Summary Hepatitis B e antigen (HBeAg) seroconversion experienced during nucleo(s)tide ana‐ logue (NUC) therapy is often not sustained. We aimed to study whether hepatitis B core‐related antigen (HBcrAg) levels predict sustained HBeAg seroconversion in pa‐ tients treated with NUCs. We studied HBeAg‐positive patients treated with NUCs for at least 6 months. We quantified HBcrAg at baseline and at the time of HBeAg seroconversion and studied the relationship with HBeAg seroconversion and subse‐ quent relapse. HBcrAg was quantified at baseline in 196 patients; levels varied signifi‐ cantly by HBV genotype and correlated with HBsAg, HBV DNA and HBeAg. Baseline HBcrAg levels were lower in patients who achieved HBeAg seroconversion than in those who did not; the unadjusted hazard ratio (HR) was 0.802 (95% CI: 0.656‐0.980, P = 0.031); and this association was not sustained in multivariate analysis. HBcrAg remained detectable in all patients at the time of HBeAg seroconversion. Higher HBcrAg at the time of seroconversion was an independent predictor of relapse (ad‐ justed HR: 1.855 (95% CI: 1.099‐3.133, P = 0.021), and none of the patients with HBcrAg < 4.90 log U/mL experienced relapse. Baseline HBcrAg is not an independ‐ ent predictor of HBeAg seroconversion during NUC therapy. HBcrAg remains de‐ tectable in patients after HBeAg seroconversion. Patients with lower levels at the time of seroconversion have a higher probability of sustained HBeAg seroconversion.

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Journal Journal of Viral Hepatitis
Sonneveld, M.J, van Oord, G.W, van Campenhout, M.J., de Man, R.A, Janssen, HLA, de Knegt, R.J, … Eijck, A.A. (2019). Relationship between hepatitis B core-related antigen levels and sustained HBeAg seroconversion in patients treated with nucleo(s)tide analogues. Journal of Viral Hepatitis, 26(7), 828–834. doi:10.1111/jvh.13097