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Long-term effect of interferon plus ribavirin on hepatitis B surface antigen seroclearance in patients dually infected with hepatitis B and C viruses.

Yeh ML, Hung CH, Huang JF, Liu CJ, Lee CM, Dai CY, Wang JH, Lin ZY, Lu SN, Hu TH, Yu ML, Kao JH, Chuang WL, Chen PJ, Chen DS - PLoS ONE (2011)

Bottom Line: HCV response did not correlate to HBsAg loss.We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients.Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance.

View Article: PubMed Central - PubMed

Affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

ABSTRACT

Background: Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg) seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV), but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients.

Methodology/principal findings: Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5%) patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1) years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR), 95% confidence intervals (CI) of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745). Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss.

Conclusions: We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance.

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5-year cumulative probability of HBsAg seroclearance was significantly associated with LC and HBV DNA.Using the Kaplan-Meier method, the 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000). HBsAg, hepatitis B surface antigen; LC, liver cirrhosis; HBV, hepatitis B virus; EOT, end of treatment.
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pone-0020752-g002: 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC and HBV DNA.Using the Kaplan-Meier method, the 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000). HBsAg, hepatitis B surface antigen; LC, liver cirrhosis; HBV, hepatitis B virus; EOT, end of treatment.

Mentions: Fifteen patients had HBsAg seroclearance during the follow-up period with a 5-year cumulative incidence of 25.6% (Figure 1a). The annual incidence was 5.5% per person year. We analyzed baseline and follow-up factors associated with HBsAg seroclearance (Table 2). Baseline HBV DNA negativity (P = 0.043) and HBV DNA negativity 1 year after EOT (P = 0.002) were significantly positive factors associated with HBsAg seroclearance in univariate analysis. HBsAg seroclearance developed among 29.4% (10/34) of patients with baseline HBV DNA negativity and 38.5% (10/26) of patients with HBV DNA negativity 1 year after EOT, which was significantly higher than the 10.6% (5/47) among patients with baseline HBV DNA positivity (p = 0.043) and the 5.1% (2/39) among patients with HBV DNA positivity 1 year after EOT (P = 0.002), respectively. Baseline HCV RNA level and HCV SVR achievement were not associated with HBsAg seroclearance. Using the Kaplan-Meier method, we observed that the cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000, Figure 2). In multivariate analysis by using Cox regression hazard analysis, LC (P = 0.013; odds ratio = 16.6; 95% CI = 1.8–153.0) and HBV DNA negativity 1 year after EOT (P = 0.023; odds ratio = 9.2; 95% CI = 1.4–62.1) were the independent factors associated with HBsAg seroclearance.


Long-term effect of interferon plus ribavirin on hepatitis B surface antigen seroclearance in patients dually infected with hepatitis B and C viruses.

Yeh ML, Hung CH, Huang JF, Liu CJ, Lee CM, Dai CY, Wang JH, Lin ZY, Lu SN, Hu TH, Yu ML, Kao JH, Chuang WL, Chen PJ, Chen DS - PLoS ONE (2011)

5-year cumulative probability of HBsAg seroclearance was significantly associated with LC and HBV DNA.Using the Kaplan-Meier method, the 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000). HBsAg, hepatitis B surface antigen; LC, liver cirrhosis; HBV, hepatitis B virus; EOT, end of treatment.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3113900&req=5

pone-0020752-g002: 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC and HBV DNA.Using the Kaplan-Meier method, the 5-year cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000). HBsAg, hepatitis B surface antigen; LC, liver cirrhosis; HBV, hepatitis B virus; EOT, end of treatment.
Mentions: Fifteen patients had HBsAg seroclearance during the follow-up period with a 5-year cumulative incidence of 25.6% (Figure 1a). The annual incidence was 5.5% per person year. We analyzed baseline and follow-up factors associated with HBsAg seroclearance (Table 2). Baseline HBV DNA negativity (P = 0.043) and HBV DNA negativity 1 year after EOT (P = 0.002) were significantly positive factors associated with HBsAg seroclearance in univariate analysis. HBsAg seroclearance developed among 29.4% (10/34) of patients with baseline HBV DNA negativity and 38.5% (10/26) of patients with HBV DNA negativity 1 year after EOT, which was significantly higher than the 10.6% (5/47) among patients with baseline HBV DNA positivity (p = 0.043) and the 5.1% (2/39) among patients with HBV DNA positivity 1 year after EOT (P = 0.002), respectively. Baseline HCV RNA level and HCV SVR achievement were not associated with HBsAg seroclearance. Using the Kaplan-Meier method, we observed that the cumulative probability of HBsAg seroclearance was significantly associated with LC (P = 0.007), baseline HBV DNA negativity (P = 0.012) and HBV DNA negativity 1 year after EOT (P = 0.000, Figure 2). In multivariate analysis by using Cox regression hazard analysis, LC (P = 0.013; odds ratio = 16.6; 95% CI = 1.8–153.0) and HBV DNA negativity 1 year after EOT (P = 0.023; odds ratio = 9.2; 95% CI = 1.4–62.1) were the independent factors associated with HBsAg seroclearance.

Bottom Line: HCV response did not correlate to HBsAg loss.We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients.Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance.

View Article: PubMed Central - PubMed

Affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

ABSTRACT

Background: Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg) seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV), but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients.

Methodology/principal findings: Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5%) patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1) years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR), 95% confidence intervals (CI) of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745). Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss.

Conclusions: We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance.

Show MeSH
Related in: MedlinePlus