Journal of infection in developing countries · 2025
HBeAg clearance in chronic Hepatitis B: is it predictable?
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
İlgar Tuba, Özşahin Aybegüm, Mahmutoğlu Çolak Sudem, Yıldız İlknur Esen, Kostakoğlu Uğur, Ertürk Ayşe
Аннотация
INTRODUCTION: Prediction of HBeAg loss is crucial for understanding the prognosis of chronic hepatitis B (CHB) and determining when to discontinue treatment. We aimed to identify factors predicting HBeAg clearance in patients undergoing antiviral treatment for HBeAg-positive CHB.
METHODOLOGY: This retrospective study included patients who started antiviral treatment for HBeAg-positive CHB from January 1, 2008, to December 31, 2022, with at least one year of follow-up. We evaluated age, platelet count, treatment duration, ALT × Upper limit of normal (ULN), AST × ULN, AST/ALT ratio, Albumin-Bilirubin grade (ALBI), Platelet-Albumin-Bilirubin grade (PALBI), AST-Platelet ratio index (APRI), and Fibrosis-4 (FIB-4) parameters. ROC analysis was used to assess these parameter's ability to predict HBeAg loss.
RESULTS: Ninety-four patients were included, 43 (45.7%) of whom were female. HBeAg clearance occurred in 32 (34%) patients. Treatment duration was significantly longer in patients with HBeAg clearance (p = 0.003). Patients with HBeAg clearance had significantly higher median age, fibrosis score (FS), APRI, and FIB-4 values (p = 0.028, p = 0.024, p = 0.008, and p = 0.003, respectively) and lower mean platelet count (p = 0.010) at treatment initiation. ROC analysis identified age, FS, APRI, FIB-4, and platelet count as significant predictors, with APRI having the highest area under the curve (AUC = 0.771, p = 0.007, sensitivity 65%, specificity 66.7% for the cut-off value of 0.71).
CONCLUSIONS: This study highlights the potential of FIB-4, platelet count, and particularly APRI in predicting HBeAg clearance. These findings can aid clinicians in optimizing treatment strategies and improving patient outcomes.
METHODOLOGY: This retrospective study included patients who started antiviral treatment for HBeAg-positive CHB from January 1, 2008, to December 31, 2022, with at least one year of follow-up. We evaluated age, platelet count, treatment duration, ALT × Upper limit of normal (ULN), AST × ULN, AST/ALT ratio, Albumin-Bilirubin grade (ALBI), Platelet-Albumin-Bilirubin grade (PALBI), AST-Platelet ratio index (APRI), and Fibrosis-4 (FIB-4) parameters. ROC analysis was used to assess these parameter's ability to predict HBeAg loss.
RESULTS: Ninety-four patients were included, 43 (45.7%) of whom were female. HBeAg clearance occurred in 32 (34%) patients. Treatment duration was significantly longer in patients with HBeAg clearance (p = 0.003). Patients with HBeAg clearance had significantly higher median age, fibrosis score (FS), APRI, and FIB-4 values (p = 0.028, p = 0.024, p = 0.008, and p = 0.003, respectively) and lower mean platelet count (p = 0.010) at treatment initiation. ROC analysis identified age, FS, APRI, FIB-4, and platelet count as significant predictors, with APRI having the highest area under the curve (AUC = 0.771, p = 0.007, sensitivity 65%, specificity 66.7% for the cut-off value of 0.71).
CONCLUSIONS: This study highlights the potential of FIB-4, platelet count, and particularly APRI in predicting HBeAg clearance. These findings can aid clinicians in optimizing treatment strategies and improving patient outcomes.