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已发表论文
可溶性程序性细胞死亡蛋白 1：慢性乙型肝炎患儿接受聚乙二醇干扰素治疗时 HBsAg 消失的潜在预测指标
Authors Yang G, Gan Y, Xia M, Fu Q, Zhang M, Luo K, Wang Z
Received 3 June 2025
Accepted for publication 25 October 2025
Published 4 November 2025 Volume 2025:14 Pages 1223—1231
DOI https://doi.org/10.2147/ITT.S541485
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Michael Shurin
Guifeng Yang,1,2,* Yifan Gan,2,3,* Muye Xia,2,3,* Qunfang Fu,1 Mingxia Zhang,1 Kangxian Luo,1 Zhanhui Wang2,3
1The Group of Prevention and Therapy for CHB, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 3Key Laboratory of Infectious Diseases Research in South China (Ministry of Education), Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhanhui Wang, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China, Tel +86-20-62787314, Email wangzhh@smu.edu.cn
Purpose: Soluble programmed cell death-1 (sPD-1) level can predict hepatitis B surface antigen (HBsAg) loss in adult chronic hepatitis B (CHB) patients. However, whether sPD-1 level can serve as a potential seromarker for predicting HBsAg loss in pediatric patients remained to determine.
Patients and Methods: Ninety-two pediatric HBeAg-positive CHB patients who received peginterferon (PegIFN) therapy with available serum samples were studied retrospectively. The average follow-up time was 45.0 months. Virological biomarkers and sPD-1 were serially measured.
Results: A total of 45 (48.9%) children achieved HBsAg loss at the end of treatment (EOT), and 84.4% (38/45) of them remained HBsAg-negative at the end of follow-up. At baseline, sPD-1 levels were comparable between patients who subsequently achieved HBsAg loss and those who did not (P = 0.217). However, a significantly more pronounced increase in sPD-1 levels was observed during PegIFN treatment in the HBsAg loss group (Ptrend < 0.001). Consequently, at weeks 12, 24, and EOT, sPD-1 levels were significantly higher in children with HBsAg loss compared to those without (P < 0.001 at all time-points). In ROC curve analysis, sPD-1 had strong discriminatory ability for HBsAg loss at weeks 12 and 24, with area under ROC scores of 0.842 (95% CI, 0.744– 0.946) and 0.863 (95% CI, 0.758– 0.969), respectively, slightly lower than HBsAg but higher than HBV DNA.
Conclusion: Early on-treatment serum sPD-1 level has a potential predictive value for HBsAg loss in pediatric patients with HBeAg-positive CHB, which might provide a clue to optimize the management of PegIFN therapy. However, a prospective, multi-center study is warranted for further validation.
Keywords: Chronic hepatitis B, HBsAg loss, peginterferon, soluble programmed cell death-1
1The Group of Prevention and Therapy for CHB, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 3Key Laboratory of Infectious Diseases Research in South China (Ministry of Education), Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhanhui Wang, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China, Tel +86-20-62787314, Email wangzhh@smu.edu.cn
Purpose: Soluble programmed cell death-1 (sPD-1) level can predict hepatitis B surface antigen (HBsAg) loss in adult chronic hepatitis B (CHB) patients. However, whether sPD-1 level can serve as a potential seromarker for predicting HBsAg loss in pediatric patients remained to determine.
Patients and Methods: Ninety-two pediatric HBeAg-positive CHB patients who received peginterferon (PegIFN) therapy with available serum samples were studied retrospectively. The average follow-up time was 45.0 months. Virological biomarkers and sPD-1 were serially measured.
Results: A total of 45 (48.9%) children achieved HBsAg loss at the end of treatment (EOT), and 84.4% (38/45) of them remained HBsAg-negative at the end of follow-up. At baseline, sPD-1 levels were comparable between patients who subsequently achieved HBsAg loss and those who did not (P = 0.217). However, a significantly more pronounced increase in sPD-1 levels was observed during PegIFN treatment in the HBsAg loss group (Ptrend < 0.001). Consequently, at weeks 12, 24, and EOT, sPD-1 levels were significantly higher in children with HBsAg loss compared to those without (P < 0.001 at all time-points). In ROC curve analysis, sPD-1 had strong discriminatory ability for HBsAg loss at weeks 12 and 24, with area under ROC scores of 0.842 (95% CI, 0.744– 0.946) and 0.863 (95% CI, 0.758– 0.969), respectively, slightly lower than HBsAg but higher than HBV DNA.
Conclusion: Early on-treatment serum sPD-1 level has a potential predictive value for HBsAg loss in pediatric patients with HBeAg-positive CHB, which might provide a clue to optimize the management of PegIFN therapy. However, a prospective, multi-center study is warranted for further validation.
Keywords: Chronic hepatitis B, HBsAg loss, peginterferon, soluble programmed cell death-1