Dynamic monitoring of soluble PD-1 in CHB patients and its role in predicting PEG-IFNα-2b efficacy: a longitudinal cohort study
Description
The study aimed to monitor the dynamic alterations of sPD-1 and assess its potential as an innovative biomarker for HBsAg loss in CHB patients undergoing PEG-IFNα-2b treatment. A total of 222 CHB patients were prospectively enrolled from a real world study (The Everest Project in China, NCT 04035837). Virological indexes, sPD-1 levels and Clinical indexes were dynamically examined every 12 weeks over a period of at least 48 weeks. The correlations between sPD-1 level and key virological and biochemical parameters were analysed. Furthermore, to minimize the potential bias, patients in the cured group were matched (1:1) with those in the uncured group by propensity scores based on HBsAg levels at baseline. Then, we explored the association of sPD-1 levels with HBsAg loss and evaluated the value of sPD-1 in predicting HBsAg loss. Patients with HBsAg loss exhibited both lower sPD-1 levels and HBsAg levels. A decline in sPD-1 levels were observed during PEG-IFNα-2b treatment. While compared to uncured patients, a significant reduction in sPD-1 was observed in cured patients over time. Elevated levels of sPD-1 were observed in participants with higher levels of HBsAg. sPD-1 level was significantly correlated with HBsAg levels, and was weakly correlated with HBsAb ( P < 0.001). After propensity score matching of 74 patients in cured group with 74 patients in uncured group, sPD-1 level with a cutoff value of 37.2 pg/mL at week 24 had a good performance in predicting HBsAg loss, with an area under the curve (AUC) of 0.728 (0.640-0.802, P < 0.001).