PgRNA kinetics predict HBsAg reduction in pregnant chronic hepatitis B carriers after treatment cessation.

Abstract

Background:

Pregenomic RNA (pgRNA) and hepatitis B core-related antigen (HBcrAg) play significant roles in predicting discontinuing treatment outcomes. However, their role in pregnancy has rarely been reported. We aimed to evaluate the performance of pgRNA and HBcrAg kinetics in predicting HBeAg seroconversion and HBsAg reduction postpartum in HBeAg-positive pregnant women.

Methods:

Pregnant HBeAg-positive patients receiving antiviral prophylaxis and ceasing treatment postpartum were included. PgRNA and HBcrAg levels were measured before treatment, at 32 weeks of gestation, and at treatment withdrawal postpartum. Other virological and biochemical parameters were regularly examined until 96 weeks postpartum.

Results:

Of 76 pregnant chronic hepatitis B (CHB) carriers with a median treatment duration of 18.1 weeks, HBeAg seroconversion and HBsAg reduction >0.3 log10 IU/mL at 96 weeks postpartum occurred in 8 (10.5%) and 13 (17.1%) patients, respectively. HBsAg correlated most strongly with pgRNA, while HBeAg correlated most strongly with HBcrAg. Multivariable regression analysis revealed that postpartum pgRNA decline and peak ALT levels were independent predictors of HBsAg reduction. The area under the curve of the regression model was 0.79 and reached as high as 0.76 through bootstrapping validation. The calibration plot showed that the nomogram had a performance similar to that of the ideal model. A decision tree was established to facilitate application of the nomogram. In addition, HBcrAg kinetics, as an independent predictor, performed poorly in predicting HBeAg seroconversion.

Conclusions:

Postpartum pgRNA decline together with peak ALT levels may identify patients with a higher probability of HBsAg reduction after treatment cessation postpartum among pregnant CHB carriers receiving antiviral prophylaxis.

• Authors: Chun-Rui Wang, Xiao-Qin Liu, Hu Li, Qian Zhang, Guo-Chao Zhong, Qiao Tang, Yunan Chang, Jin-Song Wang, Yuan-Qin Duan, Peng Hu
• Journal: Frontiers in cellular and infection microbiology (Front Cell Infect Microbiol) Vol. 12 Pg. 1055774 ( 2022) ISSN: 2235-2988 [Electronic] Switzerland
• PMID: 36579348 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Wang, Liu, Li, Zhang, Zhong, Tang, Chang, Wang, Duan and Hu.

Chemical References

• Hepatitis B Surface Antigens
• Hepatitis B e Antigens
• pgRNA
• Antiviral Agents
• RNA
• Hepatitis B Core Antigens
• DNA, Viral

Topics

• Humans
• Female
• Pregnancy
• Hepatitis B Surface Antigens
• Hepatitis B, Chronic (drug therapy)
• Hepatitis B e Antigens (therapeutic use)
• Hepatitis B virus (genetics)
• Antiviral Agents (therapeutic use)
• Kinetics
• RNA
• Hepatitis B Core Antigens
• DNA, Viral (analysis)
• Withholding Treatment