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Factors associated with the effect of interferon‐α sequential therapy in order to discontinue nucleoside/nucleotide analog treatment in patients with chronic hepatitis B
Author(s) -
Matsumoto Akihiro,
Yatsuhashi Hiroshi,
Nagaoka Shinya,
Suzuki Yoshiyuki,
Hosaka Tetsuya,
Tsuge Masataka,
Chayama Kazuaki,
Kanda Tatsuo,
Yokosuka Osamu,
Nishiguchi Shuhei,
Saito Masaki,
Miyase Shiho,
Kang JongHon,
Shinkai Noboru,
Tanaka Yasuhito,
Umemura Takeji,
Tanaka Eiji
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12488
Subject(s) - hbsag , medicine , interferon , hepatology , gastroenterology , nucleoside , hepatitis b , chronic hepatitis , hepatitis b virus , nucleoside analogue , immunology , antigen , alpha interferon , virology , virus , biology , biochemistry
Aim The factors associated with the outcome of sequential therapy with interferon‐α (IFN‐α) in order to halt nucleoside/nucleotide analog (NUC) maintenance treatment for chronic hepatitis B were analyzed. Methods A total of 50 patients with chronic hepatitis B who underwent IFN‐α sequential therapy for cessation of NUC were enrolled retrospectively. The subjects received NUC plus IFN‐α for 4 weeks followed by IFN‐α alone for 20 weeks. Natural IFN‐α of 6‐MU doses was administrated three times a week. A successful response to NUC/IFN‐α sequential therapy was defined as serum hepatitis B virus (HBV) DNA below 4.0 log copies/mL, serum alanine aminotransferase (ALT) below 30 IU/L, and hepatitis B e‐antigen negativity at 24 months after completing the treatment. Results Multivariate analysis revealed that hepatitis B surface antigen (HBsAg) of 3.0 log U/mL or more ( P < 0.002) and hepatitis B core‐related antigen (hepatitis B core‐related antigen [HBcrAg]) of 4.5 log U/mL or more ( P < 0.003) at the start of IFN‐α administration were significant factors associated with a 24‐month non‐response. Maximal levels of ALT and HBV DNA during the follow‐up period after completing IFN‐α therapy were significantly related ( P < 0.001), and receiver operating characteristic analysis showed that both maximal ALT ( P < 0.001) and HBV DNA ( P < 0.001) were significantly related to the final 24‐month response. Conclusion The combinational use of HBsAg and HBcrAg levels may be useful to predict the 24‐month outcome of NUC/IFN‐α sequential therapy. Maximal levels of ALT and HBV DNA during post‐treatment follow‐up may also help monitor responses to IFN‐α sequential therapy.