Adding pegylated interferon to a current nucleos(t)ide therapy leads to HBsAg seroconversion in a subgroup of patients with chronic hepatitis B

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• 作者：Jens M. Kittner^a ; ^{Jens.kittner@unimedizin-mainz.de} ; Martin F. Sprinzl^b ; Annette Grambihler^a ; Arndt Weinmann^a ; Jö ; rn M. Schattenberg^a ; Peter R. Galle^a ; Marcus Schuchmann^a
• 关键词：HBeAg ; hepatitis B early antigen ; HBsAg ; hepatitis B surface antigen ; cccDNA ; covalently closed circular DNA ; HBV ; hepatitis B virus ; ALT ; alaninaminotransferase ; peg-IFN ; pegylated interferon ¦Á2
• 刊名：Journal of Clinical Virology
• 出版年：2012
• 出版时间：May, 2012
• 年：2012
• 卷：54
• 期：1
• 页码：93-95
• 全文大小：291 K

文摘

Background

Nucleos(t)ides effectively halt disease progression in hepatitis B but require long-term medication.

Objectives

To determine whether add-on of peg-IFN to an ongoing nucleos(t)ide therapy accelerates decline of HBsAg and induces seroconversion.

Study design

We observed HBsAg kinetics in 12 patients on a stable oral therapy with undetectable HBV-DNA who additionally received peg-IFN-alfa 2a as an individualized therapy. 3 patients were HBeAg positive. Mean baseline HBsAg was 4695 (range 16-15,120) IU/ml.

Results

A continuous decline of HBsAg was observed in 2 patients. The slope, respectively, became detectable at week 8 or 16. HBsAg had dropped by 2.90 log₁₀ or 4.25 log₁₀ fold at week 48, and anti-HBs appeared at week 40 or 32. Patient A - HBe-positive, genotype A, F3 fibrosis - had been HBV-DNA negative for 10 months receiving entecavir plus tenofovir. Previous therapy with peg-IFN had been unsuccessful, but now the patient experienced HBeAg seroconversion at week 24. Patient B - HBeAg negative, genotype D, cirrhosis - had a low initial HBsAg level of 16 U/l. Receiving entecavir, his HBV-DNA had previously been non-detectable for 27 months. In the remaining 10 patients HBsAg declined only by a mean of 0.09 log₁₀ (range 0.01-0.25 log₁₀) after 8-24 (mean 16.4) weeks, and therefore, peg-IFN was stopped. No unexpected side effects were observed.

Discussion

We observed that the add-on of peg-IFN induced HBsAg seroconversion in 2 out of 12 patients. Response rates may have been higher with prolongation of therapy. The add-on concept merits to be evaluated in a clinical trial.