Association of HBeAg decline rate from mid‐pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus‐infected mothers
There is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%)...
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| Veröffentlicht in: | Journal of viral hepatitis 2024-08, Vol.31 (8), p.439-445 |
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| container_title | Journal of viral hepatitis |
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| creator | Zhong, Wenting Zheng, Jie Yao, Naijuan Feng, Yali Zhu, Yage Jiao, Zhe Yan, Lanzhi Shi, Lei He, Yingli Chen, Tianyan |
| description | There is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p |
| doi_str_mv | 10.1111/jvh.13948 |
| format | Article |
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In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p < .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid‐pregnancy, HBeAg titre (log10 S/CO) at mid‐pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid‐pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, p = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201‐fold (OR 4.201, 95% CI: 1.382–12.773, p = .011) higher risk of developing HBeAg seroconversion (p for trend <.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut‐off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid‐pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. This decline rate can serve as a valuable clinical indicator for predicting HBeAg seroconversion.</description><identifier>ISSN: 1352-0504</identifier><identifier>ISSN: 1365-2893</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13948</identifier><identifier>PMID: 38727606</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Antigens ; Antiviral agents ; Antiviral Agents - therapeutic use ; Cohort analysis ; DNA viruses ; Female ; Hepatitis B ; Hepatitis B - immunology ; Hepatitis B e antigen ; Hepatitis B e Antigens - blood ; Hepatitis B surface antigen ; Hepatitis B virus - immunology ; Hepatitis B, Chronic - drug therapy ; Hepatitis B, Chronic - immunology ; Humans ; Immunological tolerance ; Infectious Disease Transmission, Vertical - prevention & control ; Postpartum ; Postpartum Period ; Pregnancy ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Complications, Infectious - immunology ; Retrospective Studies ; ROC Curve ; Sensitivity analysis ; Seroconversion ; Young Adult</subject><ispartof>Journal of viral hepatitis, 2024-08, Vol.31 (8), p.439-445</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3138-c4b4cb4335cda49e3bf8d66f9aa2e0bf3fdf8343e631c678212bfe42c140aa5b3</cites><orcidid>0000-0001-9444-3678 ; 0000-0001-8642-8785 ; 0000-0002-0721-5739</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13948$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13948$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38727606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhong, Wenting</creatorcontrib><creatorcontrib>Zheng, Jie</creatorcontrib><creatorcontrib>Yao, Naijuan</creatorcontrib><creatorcontrib>Feng, Yali</creatorcontrib><creatorcontrib>Zhu, Yage</creatorcontrib><creatorcontrib>Jiao, Zhe</creatorcontrib><creatorcontrib>Yan, Lanzhi</creatorcontrib><creatorcontrib>Shi, Lei</creatorcontrib><creatorcontrib>He, Yingli</creatorcontrib><creatorcontrib>Chen, Tianyan</creatorcontrib><title>Association of HBeAg decline rate from mid‐pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus‐infected mothers</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>There is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p < .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid‐pregnancy, HBeAg titre (log10 S/CO) at mid‐pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid‐pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, p = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201‐fold (OR 4.201, 95% CI: 1.382–12.773, p = .011) higher risk of developing HBeAg seroconversion (p for trend <.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut‐off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid‐pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. 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In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p < .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid‐pregnancy, HBeAg titre (log10 S/CO) at mid‐pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid‐pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, p = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201‐fold (OR 4.201, 95% CI: 1.382–12.773, p = .011) higher risk of developing HBeAg seroconversion (p for trend <.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut‐off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid‐pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. This decline rate can serve as a valuable clinical indicator for predicting HBeAg seroconversion.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38727606</pmid><doi>10.1111/jvh.13948</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9444-3678</orcidid><orcidid>https://orcid.org/0000-0001-8642-8785</orcidid><orcidid>https://orcid.org/0000-0002-0721-5739</orcidid></addata></record> |
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| subjects | Adult Antigens Antiviral agents Antiviral Agents - therapeutic use Cohort analysis DNA viruses Female Hepatitis B Hepatitis B - immunology Hepatitis B e antigen Hepatitis B e Antigens - blood Hepatitis B surface antigen Hepatitis B virus - immunology Hepatitis B, Chronic - drug therapy Hepatitis B, Chronic - immunology Humans Immunological tolerance Infectious Disease Transmission, Vertical - prevention & control Postpartum Postpartum Period Pregnancy Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - immunology Retrospective Studies ROC Curve Sensitivity analysis Seroconversion Young Adult |
| title | Association of HBeAg decline rate from mid‐pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus‐infected mothers |
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