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IMPROVED HBsAg LOSS RATE IN CHRONIC HEPATITIS B PATIENTS TREATED WITH PROLONGED PEGINTERFERON α-2A COMBINED WITH NUCLEOS(T)IDE ANALOGUE
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Reported by Jules Levin
EASL 2013 April 24-28 Amsterdam
S.Q. Wang*, K.J. Xu, J.Z. Wu, T.T. Luongo, R.G. Yang, X.X. Geng, R.G. Huang, J.M. Lin, X.X. Yang, N. Jiang
Department of Infectious Diseases, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
Program Abstract
Aims: To investigate the improved HBsAgresponse in chronic hepatitis B (CHB) patients treated with prolonged peginterferon α-2a combined with nucleos(t)ide analogue.
Methods: One hundred and fifty-two CHB patients treated with peginterferon α-2a plus nucleos(t)ide analogue from Jan 2007 to Sep 2012 were retrospectively investigated. The mean treatment duration was 79 weeks (range 24-120 weeks). Serum HBsAglevels at baseline, week 12, 24, 36, 48, 72, 96 and 120 of treatment were detected
Results: The cumulative HBsAgloss rates of patients treated at 48-week, 96-week and 120-week with peginterferon α-2a plus nucleos(t)ide analogue were 8.55% (13/152), 26.97% (41/152) and 29.61% (45/152), respectively. The time to HBsAgloss was 74.93±27.21 weeks. Most HBsAgloss occurred during week 49-96. The HBsAglevel at week 12 of treatment in 45 patients who obtained HBsAgloss was 1.91±1.27log10IU/mL, which was significantly lower than baseline (3.22±0.82log10IU/mL) (t=5.759, P< 0.01). However, the HBsAglevel at baseline in 107 patients who did not obtain HBsAgloss was 3.57±0.96 log10 IU/mL and HBsAglevels reduction at week 12, 24, 48, 96 and 120 were 0.24±0.38, 0.45±0.60, 0.83±0.84, 1.29±1.05 and 1.66±1.66 log10IU/ml, respectively (Figure 1). As expected, the HBsAglevel at week 12 of treatment was not significantly different from that at baseline in this group of patients (t=1.529, P=0.128), while that at week 96 was significantly decreased compared with week 48 (t=2.166, P=0.033).
Conclusion: Prolonged peginterferon α-2a combined with nucleos(t)ide analogue treatment could increase the cumulative HBsAgloss rate. In patients who do not obtain HBsAgloss, prolonged therapy could reduce the HBsAglevel and improve the anti-viral response. The reduction of HBsAglevel of week 12 from baseline could be a predictor of HBsAgclearance
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