Spontaneous or drug-induced loss of hepatitis B e antigen is considered a beneficial event in the disease progression of chronic hepatitis B virus infections. Mathematical models of within-host interactions are proposed; which provide insight into hepatitis B e antibody formation, its influence on hepatitis B e antigen seroclearance, and reversion of anergic cytotoxic immune responses. They predict that antibody expansion causes immune activation and hepatitis B e antigen seroclearance. Quantification of the time between antibody expansion and hepatitis B e antigen seroclearance in the presence and absence of treatment shows that potent short-term treatment speeds up the time between antibody expansion and hepatitis B e antigen seroclearance. The monthly hepatocyte turnover during this time can be increased or decreased by treatment depending on the amount of core promoter or precore mutated virus produced. The results can inform human interventions.
Keywords: HBeAb; mathematical modeling; dHBeAg; hepatitis B; seroclearance.