Quantification of serum hepatitis B surface antigen in predicting the response of pegylated interferon alfa-2a in HBeAg-positive chronic hepatitis B with prior lamivudine exposure

Abstract

AimsMajority of previous studies of pegylated interferon α-2a (PegIFNα-2a) forced on naïve chronic hepatitis B (CHB) patients, and the data of PegIFNα-2a in therapy of patients with prior exposure to nucleos(t)ide analogues is rare. This study aimed to investigate the predictive role of serum quantitative hepatitis B surface antigen (HBsAg) in predicting sustained response of PegIFNα-2a in HBeAg-positive CHB patients with prior lamivudine exposure.MethodsForty-six patients with prior lamivudine exposure received PegIFNα-2a for 12 months and followed-up for 6 months. The clinical features of responders and non-responders were compared, and the predictive role of quantitative HBsAg in predicting responders at the end of follow-up was evaluated. Responders were defined as an ALT normalization, HBeAg seroconversion and sustained virological response at the end of follow-up.ResultsIn this cohort, only 26.1% (12/46) patients were responders. The baseline characteristics of the responders and non-responders were similar; however, the rates of ALT normalization, HBV DNA undetectability and HBeAg seroconversion were all significantly higher in responders than that in non-responders. During the treatment and follow-up, the HBsAg levels were all significantly lower in responders than that in non-responders. In predicting reponders, the serum HBsAg cutoff of 6000 IU/mL at months 6 had a positive predictive value of 73.3 and a negative predictive value of 96.8%, and with an area under the receiver operating characteristic curve of 0.869.ConclusionThe responders toward PegIFNα-2a in CHB patients with prior lamivudine exposure is not high, and serum HBsAg <6000 IU/Ml at months 6 of on-treatment had a high value to predict long-term outcomes of treatment.

Response-guided therapy of regimens based on PEG-interferon for chronic hepatitis B using on-treatment hepatitis B surface antigen quantification: a meta-analysis

“…Finally, 13 studies including 9 with fulltext and 4 with conference abstracts were chosen for inclusion into the meta-analysis ( Fig. 1) [15][16][17][18][19][20][21][22][23][24][25][26][27].…”

HBsAg and HBeAg in the prediction of a clinical response to peginterferon α-2b therapy in Chinese HBeAg-positive patients

“…Recent studies have shown that serum levels of HBsAg are associated with the levels of intrahepatic covalently closed circular DNA (cccDNA), and thus, the HBsAg level has been considered a marker for the prediction of a clinical response [28, 29]. The predictive value of the HBsAg level for a clinical response to PEG-IFN therapies has been validated in CHB patients [30–32]. In the present study, we found HBsAg quantification alone at week 12 or 24 did not produce statistically convincing PPVs for an off-treatment clinical response.…”

Hepatitis B Surface Antigen Quantitation as a Predictor of Treatment Response in Chronic Hepatitis B

“…These results are similar to Lee et al [11], they found that the baseline cutoff level HBsAg of 9550 IU has AUROC = 0.823 (P < 0.001) with a sensitivity of 86.8%, a specificity of 78.9%, a PPV of 89.2%, and an NPV of 75.0%. Additionally, Weng et al [12] also found that the cutoff of 6000IU/mL of serum HBsAg at months 6 had a PPV of 73.3% and an NPV of96.8% for predicting combined responses of ALT normalization, HBVDNA negativity and HBeAg seroconversion. Our current study showed that the best indicator of response to HBV therapy was the baseline HBsAg level (AUROC 0.870) with an optimal cutoff value <1927.5 IU/mL, and at second visit HBsAg level (AUROC0.950) with an optimal cutoff value <128.5 IU/mL strengthening the clinical applicability of serum HBsAg measurements during HBV therapy.…”