Predictors of HBeAg loss after nucleos(t)ide analogues treatment for chronic hepatitis B: A preliminary finding

Entecavir (ETV) and tenofovir (TDF) are both potent antiviral agents for the treatment of chronic hepatitis B virus (HBV) infection. The primary effective endpoints of treatment have been a sustained disappearance of HBV DNA and hepatitis B e‐antigen (HBeAg) loss or seroconversion. We compared the efficacy of ETV and TDF and determined clinical factors that contributed to HBeAg loss at Pao‐Chien Hospital in Pingtung city. We conducted a retrospective study. A total of 36 consecutive patients with chronic hepatitis B (CHB) (e‐positive) antigens were treated with ETV (n = 19) and TDF (n = 17) between January 2010 and January 2018. Demographic and baseline characteristics were used for Cox proportion hazard regression models to identify variables that were predictive of ETV and TDF‐induced HBeAg loss. The alfa fetal protein (AFP) levels were higher in patients with HBeAg loss than in those without loss (P = .006). Of which, 17 (47.2%) of 36 patients achieved HBeAg loss and 12 (33.3%) patients achieved HBeAg seroconversion. None of these seroconversion patients developed serum reversion after consolidation therapy and off treatment. The cumulative rate of HBeAg loss at years 1, 2, and 3 of therapy was 22.2% (8/36), 37.0% (10/27), and 57.7% (15/26), respectively. In cumulative rate at years 1 and 2, the frequency of HBeAg loss was observed greater in virological response at 6 months (13.9% vs 8.3%, P = .013; 40% vs 22%, P = .028, respectively). In multivariate Cox regression analysis for factors associated with HBeAg loss, an increase in virological response at 6 months (adjusted hazard ratio [HR] = 4.780; 95% CI, 1.013‐22.565; P = .048) was only significant factor associated with cumulative HBeAg loss rate at year 2 (adjusted HR = 0.183; 95% CI, 0.043‐0.774; P = .021). The rapidity and efficacy of HBV DNA reduction to undetectable is the predictor of nucleos(t)ide analogue (NUC)‐induced HBeAg loss. Early undetectable HBV DNA in 6 months might be used to predict a higher likelihood of HBeAg loss within 2‐year therapy with NUC.