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Open AccessArticle

Caucasian Ethnicity, but Not Treatment Cessation Is Associated with HBsAg Loss Following Nucleos(t)ide Analogue-Induced HBeAg Seroconversion

1
Department of Gastroenterology and Hepatology, Antwerp University Hospital, 2650 Antwerp, Belgium
2
Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2650 Antwerp, Belgium
3
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, 3015 AA Rotterdam, The Netherlands
4
Toronto Centre of Liver Disease, University Health Network, Toronto General Hospital, University of Toronto, Toronto, ON M5G2C4, Canada
5
Department of Gastroenterology and Hepatology, ZNA Stuivenberg, 2060 Antwerp, Belgium
6
Department of Gastroenterology and Hepatology, Ghent University Hospital, 9000 Ghent, Belgium
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Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, 1000 Brussels, Belgium
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Department of Gastroenterology and Hepatology, GZA Antwerp, 2610 Antwerp, Belgium
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Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, 1050 Brussels, Belgium
10
Department of Hepatology, University Hospitals KULeuven, 3000 Leuven, Belgium
*
Author to whom correspondence should be addressed.
Viruses 2019, 11(8), 687; https://doi.org/10.3390/v11080687
Received: 27 June 2019 / Revised: 17 July 2019 / Accepted: 25 July 2019 / Published: 26 July 2019
(This article belongs to the Special Issue Hepatitis B Virus Reactivation)
It is well appreciated that ethnicity influences the natural history and immune responses during a chronic hepatitis B infection. In this study, we explore the effect of ethnicity and treatment cessation on Hepatitis B surface Antigen (HBsAg) seroclearance in patients with Nucleos(t)ide Analogue (NA)-induced Hepatitis B e Antigen (HBeAg) seroconversion. We performed a multi-ethnic, multicentric observational cohort study. The analyzed cohort consisted of 178 mono-infected, predominantly male (75.3%) chronic hepatitis B patients of mixed ethnicity (44.4% Asians, 48.9% Caucasians) with nucleos(t)ide analogue-induced HBeAg seroconversion. Treatment was withdrawn in 105 patients and continued in 73, leading to HBsAg loss in 14 patients off- and 16 patients on-treatment, respectively. Overall, HBsAg loss rates were not affected by treatment cessation (hazard ratio 1.45, p = 0.372), regardless of consolidation treatment duration. Caucasian ethnicity was associated with an increased chance of HBsAg loss (hazard ratio 6.70, p = 0.001), but hepatitis B virus genotype was not (p = 0.812). In conclusion, ethnicity is the most important determinant for HBsAg loss after NA-induced HBeAg seroconversion, with up to six-fold higher HBsAg loss rates in Caucasians compared to Asians, irrespective of treatment cessation and consolidation treatment duration. View Full-Text
Keywords: chronic hepatitis B; treatment cessation; HBsAg seroclearance; ethnicity chronic hepatitis B; treatment cessation; HBsAg seroclearance; ethnicity
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Van Hees, S.; Chi, H.; Hansen, B.; Bourgeois, S.; Van Vlierberghe, H.; Sersté, T.; Francque, S.; Wong, D.; Sprengers, D.; Moreno, C.; Nevens, F.; Janssen, H.; Vanwolleghem, T. Caucasian Ethnicity, but Not Treatment Cessation Is Associated with HBsAg Loss Following Nucleos(t)ide Analogue-Induced HBeAg Seroconversion. Viruses 2019, 11, 687.

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