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Durability of peginterferon alfa‐2b treatment at 5 years in patients with hepatitis B e antigen–positive chronic hepatitis B
Author(s) -
Wong Vincent WaiSun,
Wong Grace LaiHung,
Yan Kenneth KarLung,
Chim Angel MeiLing,
Chan HoiYun,
Tse ChiHang,
Choi Paul CheungLung,
Chan Anthony WingHung,
Sung Joseph JaoYiu,
Chan Henry LikYuen
Publication year - 2010
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.23568
Subject(s) - medicine , seroconversion , hbsag , hbeag , gastroenterology , lamivudine , hepatitis b virus , hepatitis b , peginterferon alfa 2a , immunology , chronic hepatitis , virus , ribavirin
Approximately 30%‐40% of patients with hepatitis B e antigen (HBeAg)‐positive chronic hepatitis B treated with peginterferon and/or lamivudine achieve HBeAg seroconversion 6 months after the end of treatment. The durability and long‐term effect of treatment are unknown. In this study, 85 HBeAg‐positive patients who received peginterferon alfa‐2b 1.5 μg/kg/week for 32 weeks and lamivudine 100 mg/day for 52 or 104 weeks were prospectively followed for 6.1 ± 1.7 years posttreatment. Twenty‐five (29%) patients had virologic response (HBeAg seroconversion and HBV DNA <10,000 copies/mL) at 5 years. The rate of HBeAg seroconversion rose progressively from 37% at the end of treatment to 60% at 5 years. Twenty‐seven (32%) and 11 (13%) patients had undetectable HBV DNA (<100 copies/mL) at the end of peginterferon treatment and at 5 years, respectively. Two (2.4%) patients achieved hepatitis B surface antigen (HBsAg) seroclearance at 2.6 and 84 months posttreatment. Among virologic responders at the end of treatment, 82% and 57% and sustained HBeAg seroconversion and virologic response at 5 years. End‐of‐treatment serum quantitative HBsAg was significantly lower in patients with sustained virologic response at 5 years (median 1,431 IU/mL versus 2,689 IU/mL [ P = 0.041]). At the last follow‐up, the liver stiffness measurement by transient elastography was 5.8 ± 2.7 kPa. Only two patients had liver stiffness suggestive of advanced fibrosis. Week 16 HBV DNA, end‐of‐treatment HBeAg seroconversion, and undetectable HBV DNA were independent factors associated with virologic response at 5 years. The duration of concomitant lamivudine treatment had no impact on any long‐term response. Conclusion: Peginterferon has high durability in HBeAg‐positive chronic hepatitis B patients with end‐of‐treatment virologic response. (Hepatology 2010;)