Predictive value of hepatic, hematological, and immunological markers and their temporal dynamics in chronic hepatitis B functional cure

Abstract

Interferon-alpha (IFNα) therapy, known for its antiviral and immunomodulatory effects, lacks reliable predictors of functional treatment response. This study addresses this gap by systematically analyzing dynamic changes in biochemical, hematological, and immunological markers during IFNα therapy. The findings validate alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as robust predictors for functional cure of chronic Hepatitis B virus (CHB), while highlighting the complementary prognostic value of within-visit fluctuations in white blood cell (WBC) counts and cytokine profiles, particularly IL-4 and IFN-γ. Furthermore, the study identifies longitudinal stability in ALT and AST levels, along with specific hematological patterns characterized by initial decline followed by gradual recovery, as predictors of functional cure. By employing generalized linear models, Cox regression, and trajectory clustering, this research provides a comprehensive framework for understanding functional treatment response dynamics of CHB. These findings are significant for clinicians and researchers aiming to refine therapeutic strategies and achieve better patient outcomes in CHB.