HBcrAg Predicts Post-IFN-α Therapy Relapse in CHB.
Yao Lin Mei LM, Mao Chuan Chun CC, Tian Yuan Y, Lu Yao Y et al.
Serum markers predicting virologic relapse after pegylated interferon-alpha (Peg-IFN-α) discontinuation in patients with chronic hepatitis B (CHB) are lacking. This study aimed to evaluate serum pregenomic RNA (pgRNA), hepatitis B core-related antigen (HBcrAg), and hepatitis B surface antigen (HBsAg) as potential predictors of Peg-IFN-α treatment outcomes and post-treatment virologic relapse in treatment-naïve patients with CHB. A total of 371 treatment-naïve patients with CHB were initially recruited for this study, and 327 patients who completed the entire follow-up period were included in the data analysis. Serum pgRNA and HBcrAg levels were measured by polymerase chain reaction (PCR)-fluorescence probing and enzyme-linked immunosorbent assay (ELISA), respectively. Among the 327 followed patients, 112 (34.25%) achieved a virologic response to Peg-IFN-α; 16 (14.29%) experienced virologic relapse over a median follow-up of 12 months. Baseline pgRNA (odds ratio [ OR], 0.571), HBcrAg ( OR, 0.539), and HBsAg ( OR, 0.356) levels correlated with treatment efficacy, demonstrating predictive values with AUCs of 0.821, 0.879, and 0.781, respectively. HBcrAg levels at treatment discontinuation were associated with virologic relapse and showed potential as predictive biomarkers (AUC, 0.790). Serum pgRNA, HBcrAg, and HBsAg correlate with Peg-IFN-α response in treatment-naïve CHB. Serum HBcrAg levels at Peg-IFN-α discontinuation show potential as a predictive biomarker for post-treatment virologic relapse and are associated with relapse risk, which may help identify high-risk patients after Peg-IFN-α cessation. Notably, this finding requires further validation in larger cohorts due to the limited number of relapse events.