Abstract
Abstract
Background
Early decline in HBsAg levels during nucleos(t)ide-analog (NA) therapy predicts subsequent HBsAg loss, but stratification tools are limited. We assessed whether a novel baseline HBV biomarker—the HBsAg glycan-isomer (HBsAgGi)—predicts 12-month HBsAg decline.
Methods
We retrospectively analysed genotype C chronic hepatitis B patients who initiated entecavir, tenofovir-disoproxil-fumarate, or tenofovir-alafenamide and had serum available for HBsAgGi measurement. Early decliners were defined as those with ≥ 0.10 log10 IU/mL HBsAg reduction after 1 year. Baseline clinical and virological parameters were compared between decliners and non-decliners and within HBsAg
Results
Of 201 screened individuals, 106 had samples for HBsAgGi testing. In this cohort, HBsAg levels continued to fall annually over 5 years in early decliners, whereas non-decliners showed almost no long-term HBsAg reduction. In univariate analyses, higher baseline HBsAg, HBV DNA, HBeAg-positivity, and HBcrAg were associated with 1-year HBsAg decline, whereas HBsAgGi was not; none remained significant in multivariable models. However, among patients with baseline HBsAg
Conclusions
Baseline HBsAgGi adds prognostic value in patients with low HBsAg, identifying those more likely to achieve on-therapy HBsAg decline and potentially informing selection for intensified or combination HBV therapies.