The presence of baseline HBsAb-Specific B cells can predict HBsAg or HBeAg seroconversion of chronic hepatitis B on treatment

Indices for predicting HBsAg or HBeAg seroconversion in patients with chronic hepatitis B virus (HBV) infection during antiviral therapy remain elusive. We aimed to investigate if the presence of HBsAb-specific B cells at baseline can predict HBsAg or HBeAg seroconversion. In this study, 134 treatment-naive patients with chronic HBV were enrolled. A baseline HBsAb-specific B cell ELISpot assay was performed for all the patients that enrolled. Serum samples were collected at 12, 24, and 48 weeks for patients treated with Peg-IFN-α, or at 1 year, 3 years, and 5 years for patients treated with NAs. Laboratory testing of HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, HBV DNA, ALT, and AST was done. We observed a significantly lower frequency of HBsAb-specific B cells in patients with chronic HBV than in healthy individuals . In the Peg-IFN-α-treated group, 41.2% of patients with baseline HBsAb-specific B cells achieved HBsAg seroconversion, while only 13.6% of patients without baseline HBsAb-specific B cells achieved HBsAg seroconversion (<i>p</i> = 0.006). By logistic regression analysis, patients with baseline HBsAb-specific B cells and HBsAg ≤ 1500 had higher HBsAg clearance at the end of treatment (<i>p</i> &lt; 0.05). In the NA-treated group, 58.3% of patients with baseline HBsAb-specific B cells achieved HBeAg seroconversion, whereas only 30.0% of patients without baseline HBsAb-specific B cells achieved HBeAg seroconversion (<i>p</i> = 0.114). Our result revealed that baseline HBsAb-specific B cells by ELISpot assay might be a valuable predictive biomarker of HBsAg or HBeAg seroconversion in patients with chronic HBV on treatment.

慢性乙型肝炎病毒（HBV）感染患者接受抗病毒治疗期间，预测乙型肝炎表面抗原（HBsAg）或乙型肝炎e抗原（HBeAg）血清学转换的相关指标仍不明确。本研究旨在探讨基线状态下乙型肝炎表面抗体（HBsAb）特异性B细胞是否可预测HBsAg或HBeAg血清学转换。本研究共纳入134例初治慢性HBV感染患者，对所有入组患者均开展了基线HBsAb特异性B细胞酶联免疫斑点试验（ELISpot）检测。接受聚乙二醇干扰素α（Peg-IFN-α）治疗的患者分别于治疗12、24、48周采集血清样本，而接受核苷（酸）类似物（NAs）治疗的患者则分别于治疗1年、3年、5年采集血清样本，并对HBsAg、HBsAb、HBeAg、乙型肝炎e抗体（HBeAb）、乙型肝炎核心抗体（HBcAb）、乙型肝炎病毒脱氧核糖核酸（HBV DNA）、丙氨酸氨基转移酶（ALT）以及天冬氨酸氨基转移酶（AST）进行了实验室检测。本研究观察到，慢性HBV感染患者的HBsAb特异性B细胞频率显著低于健康人群。在聚乙二醇干扰素α治疗组中，基线存在HBsAb特异性B细胞的患者中有41.2%实现了HBsAg血清学转换，而基线未检测到该类B细胞的患者仅13.6%实现了HBsAg血清学转换（*p* = 0.006）。经logistic回归分析，基线存在HBsAb特异性B细胞且HBsAg≤1500的患者在治疗结束时的HBsAg清除率更高（*p* < 0.05）。在核苷（酸）类似物治疗组中，基线存在HBsAb特异性B细胞的患者中有58.3%实现了HBeAg血清学转换，而基线未检测到该类B细胞的患者仅30.0%实现了HBeAg血清学转换（*p* = 0.114）。本研究结果表明，通过ELISpot试验检测的基线HBsAb特异性B细胞，或可作为慢性HBV感染患者接受治疗期间HBsAg或HBeAg血清学转换的有效预测生物标志物（biomarker）。