Source

Departments of Gastroenterology and Hepatology Virology Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands Department of Internal Medicine 3, Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria Department of Gastroenterology, Turkiye Yuksek Ihtisas Hospital, Ankara Department of Gastroenterohepatology, Istanbul University Medical School, Istanbul Department of Gastroenterology, Ege University Faculty of Medicine, Izmir, Turkey Department and Clinic of Infectious Diseases, Hepatology and Acquired Immune Deficiencies, Medical University Wroclaw, Wroclaw Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

OBJECTIVE:

Peginterferon (PEG-IFN) is considered as a first-line treatment option for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B. We aimed to evaluate the long-term response to PEG-IFN in HBeAg-negative patients.

METHODS:

All patients enrolled in the PARC study who completed the treatment phase were eligible for this long-term follow-up (LTFU) study. Patients received PEG-IFN α-2a (180 μg weekly)±ribavirin (1000-1200 mg daily) for 48 weeks and had at least one additional LTFU visit after the initial follow-up period of 24 weeks (mean duration 2.1±0.2 years). Retreated patients were considered nonresponders.

RESULTS:

Of 117 patients who completed the treatment phase, 79 (68%) were included in this LTFU study. Among 19 patients with a combined response at 24 weeks after treatment [initial responders; hepatitis B virus DNA<10 000 copies/ml (<1714 IU/ml) and normal alanine aminotransferase], 12 (63%) sustained this response through LTFU. Three additional patients showed such a response at LTFU, resulting in a total of 15 (19%) combined responders at LTFU. A marked decrease in the serum hepatitis B surface antigen (HBsAg) levels was observed in initial responders, resulting in HBsAg clearance in 26% of the patients (6% of all LTFU participants).

CONCLUSION:

About one-third of HBeAg-negative patients with a response to PEG-IFN at 24 weeks after treatment subsequently had a relapse during 2 years of follow-up. Despite the limited overall efficacy of PEG-IFN, patients responding to PEG-IFN treatment showed a marked decrease in serum HBsAg, resulting in a high rate of HBsAg clearance, which indicates the need for predictors of response to PEG-IFN in HBeAg-negative disease.