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Pegylated-interferon alpha therapy for treatment-experienced chronic hepatitis B patients.

Yeh ML, Peng CY, Dai CY, Lai HC, Huang CF, Hsieh MY, Huang JF, Chen SC, Lin ZY, Yu ML, Chuang WL - PLoS ONE (2015)

Bottom Line: No factor was significantly associated with the treatment response in the HBeAg-negative patients.Peg-IFN re-treatment is effective for a proportion of HBeAg-positive treatment-experienced patients; it has limited efficacy for HBeAg-negative treatment-experienced patients.Peg-IFN might facilitate HBsAg loss in HBeAg-negative treatment-experienced patients.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

ABSTRACT

Background: Studies are limited on pegylated interferon (Peg-IFN) therapy for chronic hepatitis B (CHB) patients who failed or relapsed on previous antiviral therapy.

Objectives: We aimed to investigate the effect of Peg-IFN therapy in treatment-experienced CHB patients.

Study design: A total of 57 treatment-experienced CHB patients at two medical centers were enrolled. All of the patients were treated with Peg-IFN α-2a at 180 μg weekly for 24 or 48 weeks. The hepatitis B serological markers and viral loads were tested every 3 months until 1 year after stopping Peg-IFN therapy. The endpoints were HBV DNA <2000IU/mL, hepatitis B e antigen (HBeAg) seroconversion, and a hepatitis B surface antigen (HBsAg) loss at 12 months post-treatment.

Results: In HBeAg-positive patients, 25.0%, 29.2%, and 12.5% of the patients achieved HBeAg seroconversion, HBV DNA <2000 IU/mL and a combined response, respectively, at 12 months post-treatment. Prior IFN therapy, a high baseline ALT level, a low creatinine level, undetectable HBV DNA at 12 weeks and a decline in HBV DNA >2 log10 IU/mL at 12 weeks of therapy were factors associated with treatment response. In HBeAg-negative patients, 9.1%, 15.2%, and 6.1% of the patients achieved undetectable HBV DNA, HBV DNA <2000 IU/mL, and an HBsAg loss, respectively, at 12 months post-treatment. No factor was significantly associated with the treatment response in the HBeAg-negative patients. The median HBsAg level declined from 3.4 to 2.6 log10 IU/mL in all the patients, and the 5-year cumulative rate of the HBsAg loss was 9.8% in the HBeAg-negative patients. Overall, none of the patients prematurely discontinued the Peg-IFN therapy.

Conclusions: Peg-IFN re-treatment is effective for a proportion of HBeAg-positive treatment-experienced patients; it has limited efficacy for HBeAg-negative treatment-experienced patients. Peg-IFN might facilitate HBsAg loss in HBeAg-negative treatment-experienced patients.

No MeSH data available.


Related in: MedlinePlus

HBsAg kinetics during and after Peg-IFN therapy.The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients.
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pone.0122259.g002: HBsAg kinetics during and after Peg-IFN therapy.The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients.

Mentions: The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients. (Fig. 2) There was no difference in the HBsAg decline between the HBeAg-positive patients with and without HBeAg seroconversion. The HBeAg-negative patients who achieved HBV DNA <2000 IU/mL at 12 months post-treatment showed continued an HBsAg decline after stopping Peg-IFN. A rebound in the HBsAg level after stopping Peg-IFN was found in the HBeAg-negative patients who did not achieve an HBV DNA <2000 IU/mL level at 12 months post-treatment. (Fig. 3)


Pegylated-interferon alpha therapy for treatment-experienced chronic hepatitis B patients.

Yeh ML, Peng CY, Dai CY, Lai HC, Huang CF, Hsieh MY, Huang JF, Chen SC, Lin ZY, Yu ML, Chuang WL - PLoS ONE (2015)

HBsAg kinetics during and after Peg-IFN therapy.The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383481&req=5

pone.0122259.g002: HBsAg kinetics during and after Peg-IFN therapy.The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients.
Mentions: The median HBsAg level from baseline to 12 months post-treatment declined from 3.4 to 2.6 log10 IU/mL in all the patients, from 3.8 to 2.7 log10 IU/mL in the HBeAg-positive patients, and from 3.2 to 2.5 log10 IU/mL in the HBeAg-negative patients. (Fig. 2) There was no difference in the HBsAg decline between the HBeAg-positive patients with and without HBeAg seroconversion. The HBeAg-negative patients who achieved HBV DNA <2000 IU/mL at 12 months post-treatment showed continued an HBsAg decline after stopping Peg-IFN. A rebound in the HBsAg level after stopping Peg-IFN was found in the HBeAg-negative patients who did not achieve an HBV DNA <2000 IU/mL level at 12 months post-treatment. (Fig. 3)

Bottom Line: No factor was significantly associated with the treatment response in the HBeAg-negative patients.Peg-IFN re-treatment is effective for a proportion of HBeAg-positive treatment-experienced patients; it has limited efficacy for HBeAg-negative treatment-experienced patients.Peg-IFN might facilitate HBsAg loss in HBeAg-negative treatment-experienced patients.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

ABSTRACT

Background: Studies are limited on pegylated interferon (Peg-IFN) therapy for chronic hepatitis B (CHB) patients who failed or relapsed on previous antiviral therapy.

Objectives: We aimed to investigate the effect of Peg-IFN therapy in treatment-experienced CHB patients.

Study design: A total of 57 treatment-experienced CHB patients at two medical centers were enrolled. All of the patients were treated with Peg-IFN α-2a at 180 μg weekly for 24 or 48 weeks. The hepatitis B serological markers and viral loads were tested every 3 months until 1 year after stopping Peg-IFN therapy. The endpoints were HBV DNA <2000IU/mL, hepatitis B e antigen (HBeAg) seroconversion, and a hepatitis B surface antigen (HBsAg) loss at 12 months post-treatment.

Results: In HBeAg-positive patients, 25.0%, 29.2%, and 12.5% of the patients achieved HBeAg seroconversion, HBV DNA <2000 IU/mL and a combined response, respectively, at 12 months post-treatment. Prior IFN therapy, a high baseline ALT level, a low creatinine level, undetectable HBV DNA at 12 weeks and a decline in HBV DNA >2 log10 IU/mL at 12 weeks of therapy were factors associated with treatment response. In HBeAg-negative patients, 9.1%, 15.2%, and 6.1% of the patients achieved undetectable HBV DNA, HBV DNA <2000 IU/mL, and an HBsAg loss, respectively, at 12 months post-treatment. No factor was significantly associated with the treatment response in the HBeAg-negative patients. The median HBsAg level declined from 3.4 to 2.6 log10 IU/mL in all the patients, and the 5-year cumulative rate of the HBsAg loss was 9.8% in the HBeAg-negative patients. Overall, none of the patients prematurely discontinued the Peg-IFN therapy.

Conclusions: Peg-IFN re-treatment is effective for a proportion of HBeAg-positive treatment-experienced patients; it has limited efficacy for HBeAg-negative treatment-experienced patients. Peg-IFN might facilitate HBsAg loss in HBeAg-negative treatment-experienced patients.

No MeSH data available.


Related in: MedlinePlus