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Sustained off therapy response after peglyated interferon favours functional cure and no disease progression in chronic hepatitis B
Author(s) -
Lee Soon Kyu,
Kwon Jung Hyun,
Lee Sung Won,
Jang Jeong Won,
Nam Heechul,
Baik Kyoung Won,
Yoo Sun Hong,
Nam Soon Woo,
Sung Pil Soo,
Bae Si Hyun,
Choi Jong Young,
Yoon Seung Kew
Publication year - 2021
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14701
Subject(s) - medicine , gastroenterology , hbsag , cirrhosis , hbeag , pegylated interferon , seroconversion , liver disease , viremia , hepatitis b , immunology , hepatitis b virus , chronic hepatitis , virus , ribavirin
Background & Aims Nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients reduces liver‐related mortality. However, long‐term outcomes after pegylated interferon (PEG‐IFN) therapy remain to be elucidated. Therefore, we aimed to investigate the long‐term effectiveness and clinical outcomes of PEG‐IFN therapy. Methods A total of 190 patients treated with PEG‐IFN for CHB or compensated cirrhosis were consecutively enrolled between 2005 and 2014, and 122 patients who completed the treatment were analysed. The initial response was assessed at 6 months post‐treatment and defined as achieving both <2000 IU/mL HBV DNA and HBeAg loss or seroconversion in the HBeAg‐positive group, and <2000 IU/mL HBV DNA in the HBeAg‐negative group. The rates of HBsAg loss, disease progression to cirrhosis or HCC, and sustained off‐therapy response, defined as not requiring further NAs because of low viremia and liver enzymes, were analysed. Results The median follow‐up period was 7.2 years. Forty‐three (35.2%) patients achieved an initial response and 53 patients (43.4%) achieved a sustained response. Initial responders displayed higher rates of sustained response than noninitial responders (69.6% vs 32.5%, P  < .001). A higher rate of HBsAg loss was observed in patients who achieved a sustained response than in non‐sustained responders (16.2% vs 2.5%, P  = .01). Disease progression to cirrhosis or HCC was observed in eight patients (6.6%) who were nonsustained responders. Conclusions During long‐term follow‐up after PEG‐IFN treatment, nearly half of patients achieved sustained response without the need of further NA and these patients displayed favourable outcomes, including HBsAg loss and no disease progression.

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