Switching to peginterferon for chronic hepatitis B patients with hepatitis B e antigen seroconversion on entecavir – A prospective study
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AbstractNucleos(t)ide analogues (NA) are effective in suppressing hepatitis B virus (HBV) replication, but most patients require long‐term treatment. This study aimed to investigate switching to peginterferon as a strategy to stop NA. Hepatitis B e antigen (HBeAg)‐positive chronic hepatitis B patients who developed HBeAg seroconversion during NA treatment were studied. All patients received open‐label peginterferon alfa‐2a 180 μg/wk for 48 weeks, and NA was stopped at week 4 of peginterferon treatment. The primary endpoint was sustained response, which was defined as negative HBeAg, positive anti‐HBe and HBV DNA <2000 IU/mL at week 72. Other secondary endpoints including HBsAg loss at week 72 were also studied. Forty‐one patients treated with entecavir for 56 ± 23 months were recruited. Sustained response was achieved in 30 patients (73%, 95% confidence interval 58%‐84%). At week 72, 31 (76%) patients had HBeAg seroconversion, 56 (23%) patients had undetectable HBV DNA, 31 (76%) patients had normal ALT, and 6 patients (15%) had HBsAg loss. Baseline HBsAg level was the best predictor for both sustained response and HBsAg loss; the best HBsAg cut‐off for sustained response was <1500 IU/mL and that for HBsAg loss was <500 IU/mL by receiver operating characteristic curve analysis. Twenty‐two of 25 (88%) patients with baseline HBsAg <1500 IU/mL had sustained response. Five of 10 (50%) patients with baseline HBsAg <500 IU/mL developed HBsAg loss. Switching to peginterferon can be considered as a treatment option in NA‐treated patients with HBeAg seroconversion, particularly among those with lower HBsAg levels.
All Author(s) ListChan HLY, Chan FWS, Hui AJ, Li MKK, Chan KH, Wong GLH, Loo CK, Chim AML, Tse CH, Wong VWS
Journal nameJournal of Viral Hepatitis
Year2019
Month1
Volume Number26
Issue Number1
PublisherWILEY
Pages126 - 135
ISSN1352-0504
eISSN1365-2893
LanguagesEnglish-United Kingdom
Keywordsclinical trial, hepatitis B e antigen, hepatitis B surface antigen, hepatitis cure, nucleotide analogue
Web of Science Subject CategoriesGastroenterology & Hepatology;Infectious Diseases;Virology;Gastroenterology & Hepatology;Infectious Diseases;Virology

Last updated on 2020-09-07 at 02:41