Patients age 40 and older who lose the hepatitis B “e” antigen (HBeAg) as a result of antiviral treatment face a high risk of its return, compared to people who lose it spontaneously (without treatment), or who lose it during treatment when they’re younger.
Researchers, writing in a report published in the May journal of Digestive Diseases and Sciences, compared 135 patients with antiviral-induced HBeAg seroconversion (loss of HBeAg and development of “e” antibodies) with 251 patients who experienced HBeAg seroconversion spontaneously.
When patients spontaneously seroconverted, various factors played roles in whether they relapsed, such as age at HBeAg seroconversion, male gender, HBV DNA levels before HBeAg seroconversion, HBV genotype C, and the presence of mutations in HBsAg (pre-S deletions).
However, in patients with antiviral-induced HBeAg seroconversion, the only risk factor for a return of HBeAg was older age at time of seroconversion. These researchers found that antiviral-treated patients who seroconverted after age 40 had higher rates of HBeAg returning than treated patients who seroconverted in their 20s and 30s. (1)
An unrelated study published in the May issue of Liver International followed 228 patients after they spontaneously cleared HBeAg and found that those who continued to have elevated viral loads were most at risk of relapse (including liver damage and increased viral load.)
Hepatitis B flares occurred in 76 (33.3%) patients over the five-year study period, and the patients who experienced a resurgence of infection were older, had higher HBV DNA levels at the time they lost HBeAg, and were male (42.7% vs 23.4% female). (2)
Source 1: www.ncbi.nlm.nih.gov/pubmed/24846794
Source 2: www.ncbi.nlm.nih.gov/pubmed/24840542