International Medical Department, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Current treatments for chronic hepatitis B (CHB) are suboptimal. Potential ways of improving the rate of sustained response include combining the immunomodulatory properties of interferon α with the antiviral potency of nucleos(t)ide analogues and extending the duration of therapy. The present study investigated the efficacy and safety of extended treatment with peginterferon α-2a (PEG IFNα-2a) in combination with lamivudine or adefovir for 96 weeks and a follow-up to 120 weeks.
Forty-seven patients with hepatitis B e-antigen (HBeAg)-positive CHB received either PEG IFNα-2a (135 μg once weekly) plus lamivudine (100 mg daily) or adefovir (10 mg daily). All patients completed 96 weeks of therapy and were followed up for a further 24 weeks.
The baseline biology characteristics and treatment effect of the two groups were similar, so we put these two groups together as PEG IFNα-2a combined with lamivudine/adefovir. All patients achieved hepatitis B virus (HBV) DNA<500 copies/mL at 96 weeks, and no one had virology rebound after stopping therapy. The rate of HBeAg seroconversion was 46.8% at 48 weeks, increased to 74.5% at 96 weeks (P = 0.006), and 72.3% at 120 weeks. Hepatitis B surface antigen (HBsAg) seroconversion rate was 6.3% at 48 weeks, increased to 21.3% at 96 weeks (P = 0.036), and 27.7% at 120 weeks.
During PEG IFNα-2a in combination with lamivudine or adefovir for 96 weeks, HBsAg and HBeAg seroconvertion are associated with the drug use time gradually to the high rate.