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Histological responses of peginterferon alpha add‐on therapy in patients with chronic hepatitis B with advanced liver fibrosis after long‐term nucleos(t)ide analog treatment
Author(s) -
Li Guojun,
Zhang Qiran,
Yu Yiqi,
Qiu Chao,
Zhang Hanyue,
Zhang Miaoqu,
Song Zhangzhang,
Yang Yusheng,
Hong Jiemin,
Lu Jian,
Li Niuniu,
Tang Quanzhen,
Xu Long,
Wang Xuanyi,
Zhang Wenhong,
Chen Zhi
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13152
Subject(s) - medicine , hbsag , gastroenterology , fibrosis , hbeag , cirrhosis , peginterferon alfa 2a , hepatitis b , chronic hepatitis , hepatitis b virus , immunology , ribavirin , virus
Although long‐term antiviral treatment with nucleos(t)ide analogs ( NA s) can lead to histological improvement in patients with chronic hepatitis B ( CHB ), a substantial proportion of patients still fail to achieve regression of fibrosis. Here, we investigated whether peginterferon alpha (Peg‐IFNα add‐on therapy had benefits on fibrosis regression in patients with sustained severe fibrosis even after long‐term NA treatment. We conducted a retrospective analysis of data from 50 patients with CHB receiving 48 weeks of Peg‐ IFN α add‐on therapy. All enrolled patients had advanced fibrosis or cirrhosis (S score ≥ 3) at baseline and underwent NA treatment for at least 1 year before Peg‐ IFN α addition. Paired liver biopsies before and after Peg‐ IFN α add‐on treatment and laboratory tests at baseline, 24 weeks of treatment, 48 weeks of treatment and long‐term follow‐up were analysed. Of the 50 patients enrolled in this study, 34 patients (68.0%) had significant regression of fibrosis, and 42 (84.0%) showed significant remission of inflammation after Peg‐ IFN α add‐on treatment. Compared with nonresponders, patients with significant histological improvement showed faster hepatitis B surface antigen ( HB sAg) decline and tended to have higher cumulative hepatitis B e antigen ( HB eAg) and HB sAg loss rates during long‐term follow‐up. Peg‐ IFN α add‐on therapy led to significant regression of fibrosis and resolution of inflammation in patients with advanced fibrosis after long‐term NA treatment.