Department of Gastroenterology and Hepatology, Academic Medical Centre (AMC), University of Amsterdam (UvA), Amsterdam, the Netherlands.
In this study we aimed to identify baseline predictors of response in chronic hepatitis B patients treated with a combination of pegylated interferon α-2a (peg-IFN) and adefovir.
We treated 92 chronic hepatitis B patients (44 HBeAg-positive and 48 HBeAg-negative) with HBV-DNA >100,000 copies/mL (>17,182 IU/mL) with peg-IFN and adefovir for 48 weeks, and followed them up for 2 years. Baseline markers for HBeAg loss, combined response (HBeAg negativity, HBV-DNA levels ≤ 2,000 IU/mL and ALT normalization), and HBsAg loss were evaluated.
Two years after treatment, rates of HBeAg loss and HBsAg loss in HBeAg-positive patients were 18/44 (41%) and 5/44 (11%), respectively. In HBeAg-negative patients, rates of combined response and HBsAg loss were 12/48 (25%) and 8/48 (17%), respectively. HBeAg-negative patients with HBsAg loss had lower baseline HBsAg levels than those without HBsAg loss (mean HBsAg 2.35 versus 3.55 log10 IU/mL, p <0.001). They also had lower HBV-DNA levels and were more often (peg-) interferon experienced. Baseline HBsAg was the only independent predictor of HBsAg loss (OR 0.02, p = 0.01).
With combination therapy of peg-IFN and adefovir for 48 weeks, a high rate of HBsAg loss was observed in both HBeAg-positive (11%) and HBeAg-negative (17%) patients two years after treatment ended. In HBeAg-negative patients, a low baseline HBsAg level was a strong predictor for HBsAg loss.