Prediction for HBsAg seroconversion in children with chronic hepatitis B

Abstract Background To establish a prediction of HBsAg seroconversion in children with chronic hepatitis B (CHB), so as to help clinicians to choose therapeutic strategy. Methods A total of 63 children with HBeAg-positive CHB aged 1 to 17 years, who admitted to the fifth medical center of Chinese PL...

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Autores principales:	Yan-Wei Zhong, Yan-Min Shi, Fang Chu, Jie Liu, Ce Shi, Jiao-Jiao Xu, Peng Liu, Yan-Jie Bai, Xiao-He Xiao, Xiu-Chang Zhang, Min Zhang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Children Chronic hepatitis B HBsAg seroconversion HBV cccDNA HBsAg Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/69472566622a47f4b653a246e8700597
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spelling	oai:doaj.org-article:69472566622a47f4b653a246e87005972021-12-05T12:26:13ZPrediction for HBsAg seroconversion in children with chronic hepatitis B10.1186/s12879-021-06883-11471-2334https://doaj.org/article/69472566622a47f4b653a246e87005972021-12-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06883-1https://doaj.org/toc/1471-2334Abstract Background To establish a prediction of HBsAg seroconversion in children with chronic hepatitis B (CHB), so as to help clinicians to choose therapeutic strategy. Methods A total of 63 children with HBeAg-positive CHB aged 1 to 17 years, who admitted to the fifth medical center of Chinese PLA general hospital and treated with interferon α (IFNα) 48 weeks were enrolled, the clinical data were measured. Based on the results of HBsAg seroconversion (HBsAg < 0.05 IU/mL and anti-HBsAg > 10 IU/L) at week 48, the patients were divided into HBsAg seroconversion (S) group and non-HBsAg seroconversion (NS) group. Multivariate COX regression was used to identify the impact factors associated with HBsAg seroconversion. A novel prediction index was established and the area under the receiver operating characteristic curve (AUROC) was used to assess the prediction for HBsAg seroconversion. Results The 63 patients were divided into S group (20.6%, 13/63) and NS group (79.4%, 50/63). Univariate and multivariate analysis identified age, baseline intrahepatic cccDNA and serum HBsAg levels were independent impact factors for HBsAg seroconversion. Intrahepatic cccDNA was positively correlated with serum HBsAg (r = 0.464, p = 0.000). AUROC of HBV cccDNA was 0.83 (95% CI 0.71 to 0.95) and AUROC of baseline HBsAg was 0.77 (95% CI 0.61 to 0.92). Intrahepatic cccDNA ≤ 0.08 log10 copies/106 cell is regarded as cutoff value, the positive predictive value(PPV) and negative predictive value(NPV) for HBsAg seroconversion were 86.8% and 60.0%, respectively, with a sensitivity of 92.0% and specificity of 56.2%. HBsAg ≤ 3.68 log10 IU/mL is used as cut off value, the PPV and NPV for HBsAg seroconversion were 91.2% and 56.3%, respectively; the sensitivity and specificity was 86.0% of 69.2%, respectively. There was no statistical difference between them for predicting HBsAg seroconversion (p = 0.146). Conclusions HBsAg seroconversion can be predicted by the baseline serum HBsAg or intrahepatic cccDNA in children with CHB. Using the index, clinicians can choose more reasonable therapeutic strategy and reduce the waste of medical resources.Yan-Wei ZhongYan-Min ShiFang ChuJie LiuCe ShiJiao-Jiao XuPeng LiuYan-Jie BaiXiao-He XiaoXiu-Chang ZhangMin ZhangBMCarticleChildrenChronic hepatitis BHBsAg seroconversionHBV cccDNAHBsAgInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Children Chronic hepatitis B HBsAg seroconversion HBV cccDNA HBsAg Infectious and parasitic diseases RC109-216
spellingShingle	Children Chronic hepatitis B HBsAg seroconversion HBV cccDNA HBsAg Infectious and parasitic diseases RC109-216 Yan-Wei Zhong Yan-Min Shi Fang Chu Jie Liu Ce Shi Jiao-Jiao Xu Peng Liu Yan-Jie Bai Xiao-He Xiao Xiu-Chang Zhang Min Zhang Prediction for HBsAg seroconversion in children with chronic hepatitis B
description	Abstract Background To establish a prediction of HBsAg seroconversion in children with chronic hepatitis B (CHB), so as to help clinicians to choose therapeutic strategy. Methods A total of 63 children with HBeAg-positive CHB aged 1 to 17 years, who admitted to the fifth medical center of Chinese PLA general hospital and treated with interferon α (IFNα) 48 weeks were enrolled, the clinical data were measured. Based on the results of HBsAg seroconversion (HBsAg < 0.05 IU/mL and anti-HBsAg > 10 IU/L) at week 48, the patients were divided into HBsAg seroconversion (S) group and non-HBsAg seroconversion (NS) group. Multivariate COX regression was used to identify the impact factors associated with HBsAg seroconversion. A novel prediction index was established and the area under the receiver operating characteristic curve (AUROC) was used to assess the prediction for HBsAg seroconversion. Results The 63 patients were divided into S group (20.6%, 13/63) and NS group (79.4%, 50/63). Univariate and multivariate analysis identified age, baseline intrahepatic cccDNA and serum HBsAg levels were independent impact factors for HBsAg seroconversion. Intrahepatic cccDNA was positively correlated with serum HBsAg (r = 0.464, p = 0.000). AUROC of HBV cccDNA was 0.83 (95% CI 0.71 to 0.95) and AUROC of baseline HBsAg was 0.77 (95% CI 0.61 to 0.92). Intrahepatic cccDNA ≤ 0.08 log10 copies/106 cell is regarded as cutoff value, the positive predictive value(PPV) and negative predictive value(NPV) for HBsAg seroconversion were 86.8% and 60.0%, respectively, with a sensitivity of 92.0% and specificity of 56.2%. HBsAg ≤ 3.68 log10 IU/mL is used as cut off value, the PPV and NPV for HBsAg seroconversion were 91.2% and 56.3%, respectively; the sensitivity and specificity was 86.0% of 69.2%, respectively. There was no statistical difference between them for predicting HBsAg seroconversion (p = 0.146). Conclusions HBsAg seroconversion can be predicted by the baseline serum HBsAg or intrahepatic cccDNA in children with CHB. Using the index, clinicians can choose more reasonable therapeutic strategy and reduce the waste of medical resources.
format	article
author	Yan-Wei Zhong Yan-Min Shi Fang Chu Jie Liu Ce Shi Jiao-Jiao Xu Peng Liu Yan-Jie Bai Xiao-He Xiao Xiu-Chang Zhang Min Zhang
author_facet	Yan-Wei Zhong Yan-Min Shi Fang Chu Jie Liu Ce Shi Jiao-Jiao Xu Peng Liu Yan-Jie Bai Xiao-He Xiao Xiu-Chang Zhang Min Zhang
author_sort	Yan-Wei Zhong
title	Prediction for HBsAg seroconversion in children with chronic hepatitis B
title_short	Prediction for HBsAg seroconversion in children with chronic hepatitis B
title_full	Prediction for HBsAg seroconversion in children with chronic hepatitis B
title_fullStr	Prediction for HBsAg seroconversion in children with chronic hepatitis B
title_full_unstemmed	Prediction for HBsAg seroconversion in children with chronic hepatitis B
title_sort	prediction for hbsag seroconversion in children with chronic hepatitis b
publisher	BMC
publishDate	2021
url	https://doaj.org/article/69472566622a47f4b653a246e8700597
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Prediction for HBsAg seroconversion in children with chronic hepatitis B

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