Prevalence and clinical significance of HBeAg-positive chronic hepatitis B patients with and without anti-HBe antibody

The clinical significance of the coexistence of hepatitis B e antigen (HBeAg) and antibodies against HBeAg (anti-HBe) in patients with chronic hepatitis B (CHB) remains unclear. This study investigated the clinical features and phase transition of patients with coexisting HBeAg/anti-HBe. A total of...

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Main Authors: Ruifei Xue, Jian Wang, Jie Zhan, Zhiyi Zhang, Suling Jiang, Jiacheng Liu, Li Wang, Xiaomin Yan, Shengxia Yin, Xin Tong, Weimao Ding, Jie Li, Yuxin Chen, Rui Huang, Chao Wu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Virulence
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Online Access:https://www.tandfonline.com/doi/10.1080/21505594.2025.2534079
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Summary:The clinical significance of the coexistence of hepatitis B e antigen (HBeAg) and antibodies against HBeAg (anti-HBe) in patients with chronic hepatitis B (CHB) remains unclear. This study investigated the clinical features and phase transition of patients with coexisting HBeAg/anti-HBe. A total of 840 treatment-naïve HBeAg-positive CHB patients from two medical centres were included. Cox regression analysis was used to analyze factors associated with HBeAg clearance and seroconversion. Eighty-six patients (10.2%) had coexisting HBeAg/anti-HBe. Patients with anti-HBe were older (39.0 vs. 34.0 years, p=0.016) and had a higher FIB-4 values (1.5 vs. 1.0, p<0.001) than those without anti-HBe. The proportions of HBeAg clearance (41.9% vs. 16.2%, p<0.001) and HBeAg seroconversion (37.2% vs. 11.4%, p<0.001) were significantly higher in patients with coexisting HBeAg/anti-HBe than in those without anti-HBe during the follow-up period. Surprisingly, 39.5% of patients with anti-HBe transitioned to HBeAg-positive and anti-HBe-negative status. A total of 4.7% of patients with HBeAg and anti-HBe coexistence transitioned to HBeAg-negative and anti-HBe-negative status. Patients with anti-HBe had higher cumulative HBeAg clearance and seroconversion rates than those without anti-HBe (p<0.001). HBeAg/anti-HBe coexistence was associated with higher HBeAg clearance (HR 2.960, 95%CI 1.828–4.791, p<0.001) and HBeAg seroconversion (HR 4.018, 95% CI 2.372–6.805, p<0.001). Patients with coexisting HBeAg and anti-HBe had a higher likelihood of HBeAg clearance and seroconversion. Close follow-up is needed to monitor the phase transitions in patients with coexistence of HBeAg and anti-HBe patients.
ISSN:2150-5594
2150-5608