HBsAg protein composition and clinical outcomes in chronic hepatitis D and variations across HBeAg-negative chronic HBsAg carriers

Background & AimsHBsAg proteins are useful to identify HBV inactive carriers (ICs), but data on chronic hepatitis D (CHD) scarce. This study aimed describe HBsAg composition in CHD, its changes during the evolution and potential association with clinical outcomes. Besides, we assess of across different genotype validate previous results an independent cohort.MethodsQuantitative (qHBsAg), medium large (MHBs, LHBs) were measured two cohorts: 1) CHD: cross-sectional samples from European institutions (N=46); Outcomes assessed a retrospective-prospective those patients follow-up (FU) >1 year (N=36), longitudinal >5 years apart (N=12); 2) HBeAg-negative subjects: (N=141).ResultsForty-one (89%) CHD had detectable HDV-RNA, presence HDV-RNA was associated higher LHBs% (p=0.010). Baseline MHBs (p=0.051) MHBs% (p=0.086) tended be developing outcomes (9/36, 25%) after median FU 5.9 years. Subjects which became spontaneously undetectable (5/31, 16.1%) present lower (p=0.085). In study, observed (p=0.041), whereas remained stable (p=0.209). Regarding HBV, ICs showed (p=0.027). LHBs differed significantly according HBV-genotype, regardless phase.ConclusionsCHD subjects presented than undetectable. A trend have baseline who developed or HDV-RNA. validates HBV-ICs reveals HBV-genotype influence composition.Lay summaryThe Hepatitis B surface antigen delta differs HDV viral load, may help predict likelihood achieve viremia development events such as decompensation. The is also distinguish virus, it varies HBV-genotype.