Higher hepatitis B core-specific T cell response is associated with a lower risk of clinical relapse after discontinuation of oral antiviral treatment

Abstract

Background: Hepatitis B virus (HBV)-specific T cell response is a major host immune response to control the virus. However, it is still unclear how it affects long-term outcomes of chronic hepatitis B patients, especially those who stop nucleos(t)ide analogue (NA) therapy. We aimed to explore whether the HBV-specific T cell response at the end of treatment (EOT) was associated with clinical outcomes. Methods: In a prospective cohort study, 51 HBeAg-negative patients who discontinued NA therapy were enrolled. Results: In amean follow-up of 25.3months, 25 patients developed clinical relapse.We found that a stronger hepatitis B core (HBc)-specific T cell response at EOTwas associated with a lower risk of clinical relapse. Compared to the low-response group, the high-response group had a lower risk of clinical relapsewith hazard ratio of 0.21 (95% CI: 0.05e0.88). The high HBc-specific Tcell response was associated with reduced surge of HBV DNA and HBcrAg during the first year of follow-up. The T cell response at EOTwas comparable between different NA treatments. Notably, the overall HBVspecific T cell response could be partially restored along with clinical relapse; however, such reinvigorated T cell response was not associated with HBsAg seroclearance. Conclusions: A higher HBc-specific T cell response at EOTwas associated with lower risk of clinical relapse and reduced surge of HBV DNA and HBcrAg levels off NA therapy.