Abstract
The management of chronic hepatitis B (CHB) encounters challenges like suboptimal antiviral response and the lack of predictive biomarkers. In this study, the role of paternally expressed gene 10 (PEG10) in hepatitis B e antigen (HBeAg) seroconversion (HBeAg SC) was explored to identify a therapeutic target and predictive model. In total, 349 participants were recruited, and 141 HBeAg-positive patients were followed up after 48 weeks of antiviral therapy. Key genes were screened by machine learning algorithms (BORUTA, RF and LASSO). PEG10 mRNA, promoter methylation and plasma levels were examined. The effect of PEG10 was assessed by logistic regression, and HBeAg SC was predicted by nomograms. HBeAg-positive patients showed markedly elevated PEG10 mRNA expression (p < 0.001), which correlated strongly with major virological markers such as HBV DNA (r = 0.520, p < 0.001), HBeAg (r = 0.490, p < 0.001) and HBsAg (r = 0.400, p < 0.001). In addition, HBeAg-positive patients exhibited a significant reduction in PEG10 promoter methylation levels compared with controls (p < 0.001). According to logistic regression analysis, PEG10 promoter methylation status was an independent predictor of HBeAg SC. The predictive nomogram incorporating PEG10 promoter methylation ratio (PMR), albumin (ALB), aspartate aminotransferase (AST) and HBeAg demonstrated excellent clinical predictive value (area under curve (AUC) = 0.895,95% confidence interval (CI): 0.808 ~ 0.963). The methylation status of the PEG10 promoter represents a promising biomarker for the prediction of HBeAg SC in patients with CHB. CLINICAL TRIAL REGISTRATION: Not applicable.