Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B

IntroductionAchieving functional cure of chronic hepatitis B (CHB), characterized by the loss of HBV DNA and HBsAg, remains challenging in adults but demonstrates higher success rates in children. Elucidating the factors influencing HBsAg loss in pediatric patients is crucial for optimizing treatmen...

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Main Authors: Sukjin Hong, Jun Hyun Hwang, Keumoung Kim, Younghae Do, Naeun Kwak, Hyo Rim Suh, Sujin Choi, Ben Kang, Byung-Ho Choe
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1539300/full
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author Sukjin Hong
Jun Hyun Hwang
Keumoung Kim
Younghae Do
Naeun Kwak
Hyo Rim Suh
Sujin Choi
Ben Kang
Byung-Ho Choe
author_facet Sukjin Hong
Jun Hyun Hwang
Keumoung Kim
Younghae Do
Naeun Kwak
Hyo Rim Suh
Sujin Choi
Ben Kang
Byung-Ho Choe
author_sort Sukjin Hong
collection DOAJ
description IntroductionAchieving functional cure of chronic hepatitis B (CHB), characterized by the loss of HBV DNA and HBsAg, remains challenging in adults but demonstrates higher success rates in children. Elucidating the factors influencing HBsAg loss in pediatric patients is crucial for optimizing treatment strategies. This study aimed to evaluate the predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric CHB and develop a predictive model incorporating these dynamics.Material and methodsThis retrospective cohort study analyzed 119 children aged 1–18 years with CHB treated with nucleos(t)ide analogues. Patient outcomes were evaluated using two independent classification approaches: HBsAg loss status and age stratification (≤6 vs. >6 years). Treatment response was assessed through longitudinal HBeAg titer measurements during the first 12 months. Based on identified predictors, a logistic regression model was developed incorporating age and HBeAg titer dynamics to predict HBsAg clearance probability.ResultsThe study population exhibited a median age of 6.2 years. Factors associated with HBsAg loss encompassed younger age, female sex, and absence of breakthrough. In multivariate analysis, younger age was identified as the only significant factor. The cumulative HBsAg loss rate demonstrated markedly higher values in the ≤6 years group (Hazard ratio 7.69). HBeAg titer decline exhibited significantly steeper trajectories in the HBsAg loss group. The developed predictive model, “Log Odds = −1.182 + 0.308 × log_reduction−0.205 × age”, demonstrated good performance with high accuracy.ConclusionsEarly HBeAg titer dynamics combined with age at treatment initiation may serve as useful predictors of HBsAg clearance in pediatric CHB. Our predictive model, utilizing readily available semi-quantitative HBeAg measurements, could potentially assist clinicians in therapeutic decision-making and individualized treatment strategies.
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spelling doaj-art-af2c269ff6384844a4266e63b4e513a22025-08-20T01:55:12ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-04-011310.3389/fped.2025.15393001539300Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis BSukjin Hong0Jun Hyun Hwang1Keumoung Kim2Younghae Do3Naeun Kwak4Hyo Rim Suh5Sujin Choi6Ben Kang7Byung-Ho Choe8Department of Pediatrics, School of Medicine, Daegu Catholic University, Daegu, Republic of KoreaDepartment of Preventive Medicine, School of Medicine, Daegu Catholic University, Daegu, Republic of KoreaDepartment of Mathematics, Nonlinear Dynamics & Mathematical Application Center, Kyungpook National University, Daegu, Republic of KoreaDepartment of Mathematics, Nonlinear Dynamics & Mathematical Application Center, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaIntroductionAchieving functional cure of chronic hepatitis B (CHB), characterized by the loss of HBV DNA and HBsAg, remains challenging in adults but demonstrates higher success rates in children. Elucidating the factors influencing HBsAg loss in pediatric patients is crucial for optimizing treatment strategies. This study aimed to evaluate the predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric CHB and develop a predictive model incorporating these dynamics.Material and methodsThis retrospective cohort study analyzed 119 children aged 1–18 years with CHB treated with nucleos(t)ide analogues. Patient outcomes were evaluated using two independent classification approaches: HBsAg loss status and age stratification (≤6 vs. >6 years). Treatment response was assessed through longitudinal HBeAg titer measurements during the first 12 months. Based on identified predictors, a logistic regression model was developed incorporating age and HBeAg titer dynamics to predict HBsAg clearance probability.ResultsThe study population exhibited a median age of 6.2 years. Factors associated with HBsAg loss encompassed younger age, female sex, and absence of breakthrough. In multivariate analysis, younger age was identified as the only significant factor. The cumulative HBsAg loss rate demonstrated markedly higher values in the ≤6 years group (Hazard ratio 7.69). HBeAg titer decline exhibited significantly steeper trajectories in the HBsAg loss group. The developed predictive model, “Log Odds = −1.182 + 0.308 × log_reduction−0.205 × age”, demonstrated good performance with high accuracy.ConclusionsEarly HBeAg titer dynamics combined with age at treatment initiation may serve as useful predictors of HBsAg clearance in pediatric CHB. Our predictive model, utilizing readily available semi-quantitative HBeAg measurements, could potentially assist clinicians in therapeutic decision-making and individualized treatment strategies.https://www.frontiersin.org/articles/10.3389/fped.2025.1539300/fullhepatitis B surface antigenshepatitis B e antigensseroconversionantiviral agentschildren
spellingShingle Sukjin Hong
Jun Hyun Hwang
Keumoung Kim
Younghae Do
Naeun Kwak
Hyo Rim Suh
Sujin Choi
Ben Kang
Byung-Ho Choe
Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
Frontiers in Pediatrics
hepatitis B surface antigens
hepatitis B e antigens
seroconversion
antiviral agents
children
title Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
title_full Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
title_fullStr Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
title_full_unstemmed Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
title_short Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B
title_sort predictive value of hbeag titer dynamics for hbsag clearance in pediatric chronic hepatitis b
topic hepatitis B surface antigens
hepatitis B e antigens
seroconversion
antiviral agents
children
url https://www.frontiersin.org/articles/10.3389/fped.2025.1539300/full
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