Predictors of response to pegylated interferon in chronic hepatitis B: a real-world hospital-based analysis

Abstract

Information on the efficacy of pegylated interferon (PEG-IFN) treatment of chronic hepatitis B (CHB) patients and predictors of the response based on real-world data is limited. Consecutive 201 patients who underwent PEG-IFN treatment for CHB were reviewed. A virological response (VR) was defined as a serum HBV DNA of <2000 IU/mL, and a combined response (CR) was defined a VR accompanied by serological response for hepatitis B e antigen (HBeAg)-positive CHB. For HBeAg-positive CHB patients, the HBeAg seroconversion rate and CR rate were 30.5% and 21.2% at 48 weeks after end of treatment (EOT), respectively. Baseline alanine aminotransferase (ALT) level was associated with HBeAg seroconversion, while baseline hepatitis B s antigen (HBsAg) levels of <250 IU/mL and HBV DNA <2.5 × 107 IU/mL were strongly associated with sustained off-treatment CR. For HBeAg-negative CHB, the VR rates were 85.5%, and 27.7% at EOT, and 48 weeks after EOT, respectively; a baseline HBsAg <1,250 IU/mL was associated with sustained off-treatment VR. PEG-IFN treatment has durable HBeAg seroconversion in HBeAg-positive CHB, but results in a high risk of relapse among HBeAg-negative CHB patients. Pre-treatment HBsAg level is an important predictor of VR in CHB patients undergoing PEG-IFN treatment.

HBsAg quantification predicts off-treatment response to interferon in chronic hepatitis B patients：A retrospective study of 250 cases

“…Pretreatment HBsAg, viral load and ALT levels were highlighted to predict post-treatment response of IFN therapy. For CHB patients with pretreatment high ALT level, low viral load and low HBsAg level, treatment with IFN leads to better clinical outcomes [25][26][27][28]. Consistent with previous studies, in our study, we found that baseline ALT >4×ULN, HBV DNA <2×106 IU/mL and HBsAg <25000 IU/mL were significantly associated with EOT HBsAg ≤10 IU/mL.…”

Vitamin D-Binding protein Gene Polymorphism Predicts Pegylated Interferon-Related HBsAg Seroclearance in HBeAg-Negative Thai Chronic Hepatitis B Patients: A Multicentre Study

“…Longer follow-up period Vitamin D Pathway SNPS and Response to Pegylated-Interferon in HBeAg-Negative Patients might have additional patients with HBsAg seroclearance. However, the number is similar to previous cohort studies (Brunetto et al, 2009;Moucari et al, 2009;Peng et al, 2012;Lampertico et al, 2013;Goulis et al, 2015;Wang et al, 2016). It is of interest that these SNPs might influent more on the long-term treatment outcome, in view of HBsAg seroclearance, a further study is required.…”

Effects of pegylated interferon‐α based therapies on functional cure and the risk of hepatocellular carcinoma development in patients with chronic hepatitis B

“…Several studies have demonstrated that certain baseline factors are associated with achieving HBeAg loss/seroconversion and a sustained off‐treatment HBV DNA response in patients receiving peg‐IFN‐α‐based regimens. These factors include HBV genotypes (genotypes A and B >C and D), higher baseline ALT levels (≥2 × ULN), lower HBV DNA levels (<2.0 × 10 8 IU/mL) and lower HBsAg levels (≤25 000 IU/mL) . In Study 149, the highest HBsAg loss rate (37.5%) at EOF was observed in genotype A patients receiving TDF plus peg‐IFN‐α for 48 weeks .…”

“…These factors include HBV genotypes (genotypes A and B >C and D), 5,27,32 higher baseline ALT levels (≥2 × ULN), 16,25,27,33 lower HBV DNA levels (<2.0 × 10 8 IU/ mL) 11,16,22,27,32 and lower HBsAg levels (≤25 000 IU/mL). 25,[32][33][34] In Study 149, the highest HBsAg loss rate (37.5%) at EOF was observed in genotype A patients receiving TDF plus peg-IFNα for 48 weeks. 13 A long-term, follow-up cohort study showed that baseline age and HBV genotype A were associated with the HBsAg loss rate at 5 years of off-treatment in HBeAg-positive patients treated with peg-IFNα plus ADV.…”