Abstract
BACKGROUND: This study aimed to analyze the risk factors and predicted model for clinical relapse after discontinuation of antiviral therapy in patients with chronic hepatitis B (CHB). METHODS: A retrospective analysis was conducted on the clinical data of 99 CHB patients who met the discontinuation criteria and were treated at Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe State) from March 2020 to December 2022. All subjects received nucleos(t)ide analogs (NAs) or interferon-based antiviral therapy and discontinued treatment once they met the cessation criteria, followed by a 2-year follow-up. Based on relapse status, patients were divided into a relapse group and a non-relapse group. Clinical characteristics were compared between the two groups. A multivariate logistic regression analysis was performed to analyze the independent risk factors for clinical relapse within 2 years after treatment cessation. RESULTS: During the 2-year follow-up, 45 patients (45.45%) experienced clinical relapse after discontinuation. Compared with the non-relapse group, the relapse group exhibited significantly higher age, HBsAg levels at treatment cessation, and HBV DNA load at discontinuation (p < 0.05), as well as a shorter total duration of antiviral therapy (p < 0.05). Multivariate analysis revealed that age, total antiviral treatment duration, HBV DNA load at discontinuation, and HBsAg levels at cessation were independent risk factors for clinical relapse of CHB patients (p < 0.05). A combined predictive model was constructed based on multivariate logistic regression coefficients: combined model = -17.497 + 0.181 × age + (-0.123) × total antiviral duration + 1.746 × HBV DNA at discontinuation + 0.032 × HBsAg at discontinuation. ROC analysis demonstrated that the AUC of the combined model was 0.945 (95% CI: 0.902-0.987) for predicting 2-year clinical relapse, with a sensitivity of 91.11% and specificity of 83.33%. Spearman correlation analysis indicated that patient age and HBV DNA load at discontinuation were negatively correlated with time to relapse (p < 0.05), whereas HBsAg levels showed no significant correlation with total antiviral duration (p > 0.05). CONCLUSIONS: Age, HBV DNA load at discontinuation, HBsAg quantification at discontinuation, and the total antiviral duration were identified as key factors influencing clinical relapse after cessation of antiviral therapy in patients with CHB. A predictive model incorporating these factors demonstrated good clinical predictive value.