studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1181A
3.7 years and the median time from HBsAg loss to NA cessation
was 0.6 years. At NA cessation, 61% of the patients
were anti-HBs positive for a median duration of 0.5 years.
After NA cessation, 4 (9%) patients relapsed. Three of them
developed detectable HBV DNA (23, 223 and 1320 IU/mL)
within the first 3 months. All 3 patients remained HBsAg negative,
one was retreated while the other 2 returned to HBV
DNA 1
year and did not have significant co-morbidities were enrolled.
Fasting serum, spot and 24 hour urine samples were collected.
Fractional excretion of potassium (FEK + ), phosphate (FEPO 4
),
uric acid (FEUA), urinary β2MG/creatinine (Cr) and urine protein/creatinine
ratio (UPCR) were calculated. The criteria of
renal loss were defined as follow: proteinuria (24-hour urine
protein >150 mg or positive protein dipstick), glucosuria while
having normoglycemia, phosphate loss (FEPO 4
>18%), uric
acid loss (FEUA>15%), hypokalemia with renal K + loss, normal
gap metabolic acidosis. Subclinical and definite proximal RTD
was defined when there was a presence of 2 and ≥3 criteria,
respectively. Receiver Operating Characteristic (ROC) was
analyzed. The comparison of areas under the ROC was done.
Results: Of 92 patients, subclinical and proximal RTD were
seen in 15 (16.3%) and 9 (9.8%) patients. Median (range)
duration of nucleotide analogue usage in normal, subclinical
and definite proximal RTD were 45 (12-116), 66 (15-114),
81 (42-108) months. The performance of spot urine protein,
UPCR, urinary β2MG, urinary β2MG/Cr, FEPO 4
and FEUA
for detecting proximal RTD were showed in Table 1. Urinary
β2MG yielded the highest AUROC [0.888 (0.804-0.972)]. At
the cutoff of 300 mcg/L, urinary β2MG was 91.67% sensitivity
and 76.47% specificity. There was no difference of diagnostic
accuracy among tests (P=0.23). For detecting subclinical
proximal RTD, urinary β2MG had the highest AUROC [0.822
(0.699-0.946)]. At the cutoff of 300 mcg/L, urinary β2MG
was 86.67% sensitivity and 77.27% specificity. Conclusions:
16.3% and 9.8% CHB patients on nucleotide analogues developed
subclinical and definite proximal RTD. Urinary β2MG
had the highest accuracy for detecting proximal RTD. During
nucleotide analogue treatment, urinary β2MG or UPCR should
be monitored.
Table 1. Receiver Operating Characteristic (ROC) analysis for
detecting proximal RTD