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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Viral Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1528758
This article is part of the Research Topic Screening and Mechanistic Study of Host Factors in the Hepatitis B Virus Life Cycle: Insights into Interferon Therapy and Its Side Effects View all articles

Exploring using HBsAg to Predict Interferon Treatment Course to Achieve Clinical Cure in Chronic Hepatitis B Patients: a clinical study

Provisionally accepted
Fei Yan Fei Yan 1Fei Tang Fei Tang 2Jing Chen Jing Chen 1Yicheng Lin Yicheng Lin 1*Qin Du Qin Du 3*Weili Yin Weili Yin 2*Liang Jing Liang Jing 2Lei Liu Lei Liu 2*Fang Wang Fang Wang 2*Baiguo Xu Baiguo Xu 2*Qing Ye Qing Ye 2*Huiling Xiang Huiling Xiang 2*
  • 1 The Third Central Clinical College of Tianjin Medical University, Tianjin Third Central Hospital, Tianjin, China
  • 2 Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
  • 3 Nankai University Affiliated Third Center Hospital, Tianjin Third Central Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    Objective: Although pegylated interferon α-2b (PEG-IFN α-2b) therapy for chronic hepatitis B has received increasing attention, determining the optimal treatment course remains challenging. This research aimed to develop a efficient model for predicting interferon (IFN) treatment course. Methods: Patients with chronic hepatitis B, undergoing PEG-IFN α-2b monotherapy or combined with NAs (Nucleoside Analogs), were recruited from January 2018 to December 2023 at Tianjin Third Central Hospital. All patients achieved hepatitis B surface antigen (HBsAg) clearance post-treatment. Result: The study enrolled 176 patients with chronic hepatitis B, with the median IFN treatment course of 35.23±25.22 weeks. They were randomly divided into two cohorts in a ratio of 7:3. And there were 123 patients in the training cohort and 53 patients in the validation cohort. Univariable and multivariable analyses demonstrated that baseline HBsAg, 12 weeks HBsAg and the presence of cirrhosis significantly influenced IFN treatment course, and both are risk factors (β=7.27,4.27,10.91; p<0.05). After adjusting for confounding factors, HBsAg remained a significant predictor (β=6.99, 95%CI: 3.59,10.40; p<0.05), which was finally included to establish the model. The actual and predicted values in the validation cohort were highly matched, meanwhile the mean absolute percentage error (MAPE), root mean square error (RMSE) and accuracy (ACC) of the validation cohort were calculated. External validation also suggests that the model can be used as a tool for initial assessment. Conclusion: Baseline HBsAg in chronic hepatitis B patients were a risk factor for prolonged IFN treatment course with a positive correlation. Ultimately, a personalized model based on baseline HBsAg levels can be established to roughly estimate the duration of interferon therapy prior to treatment initiation, thereby guiding clinical decision-making.

    Keywords: Chronic hepatitis B (CHB), Clinical cure, Hepatitis b surface antigen (HBsAg), PEG-IFN α, Model

    Received: 15 Nov 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Yan, Tang, Chen, Lin, Du, Yin, Jing, Liu, Wang, Xu, Ye and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yicheng Lin, The Third Central Clinical College of Tianjin Medical University, Tianjin Third Central Hospital, Tianjin, China
    Qin Du, Nankai University Affiliated Third Center Hospital, Tianjin Third Central Hospital, Tianjin, China
    Weili Yin, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
    Lei Liu, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
    Fang Wang, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
    Baiguo Xu, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
    Qing Ye, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
    Huiling Xiang, Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China

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