Baseline Hepatitis B Surface Antigen (Hbsag) as Predictor of Sustained Hbsag Loss in Chronic Hepatitis B Patients Treated with Pegylated Interferon-α2A and Adefovir

Takkenberg, R. Bart; Jansen, Louis; Niet, A. de; Zaaijer, Hans L.; Weegink, Christine J.; Terpstra, Valeska; Dijkgraaf, Marcel G. W.; Molenkamp, Richard; Jansen, Petér L. M.; Koot, M.; Rijckborst, Vincent; Janssen, Harry L.A.; Beld, Marcel; Reesink, H. W.

doi:10.3851/imp2580

Cited by 70 publications

(76 citation statements)

References 31 publications

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“…In other clinical trials, sustained virological response rates ranged from 20.0% to 35%, and the HBsAg loss rate ranged from 4.4% to 5.8% at 24 to 48 weeks of off‐treatment in HBeAg‐negative patients treated with de novo combinations of peg‐IFN‐α and NAs for 48 weeks. Takkenberg et al .…”

Section: Efficacy Of Peg‐ifnα−containing Regimens In Achieving a Funcmentioning

confidence: 95%

Effects of pegylated interferon‐α based therapies on functional cure and the risk of hepatocellular carcinoma development in patients with chronic hepatitis B

Ren

Huang

2019

Journal of Viral Hepatitis

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Chronic hepatitis B virus (HBV) infection continues to pose a serious global health threat and a significant socio‐economic burden in many areas of the world. Almost all current clinical practice guidelines on the management of chronic hepatitis B (CHB) infection recommend that eligible patients pursue the optimal treatment endpoint, which is defined as HBsAg loss with or without anti‐HBs seroconversion. This review describes the effects of various regimens containing pegylated interferon (peg‐IFN)‐alpha on functional cure and the outcome of hepatocellular carcinoma (HCC) in patients with CHB. Peg‐IFN‐α monotherapy is a treatment option recommended by local and international clinical practice guidelines to help more CHB patients achieve a sustained off‐treatment virological response, which is particularly appropriate for relatively young patients who demand a finite treatment approach. Peg‐IFN‐α add‐on or sequential therapy in patients who have achieved a suppressed viral load after nucleos(t)ide analog (NA) therapy may offer further benefits on HBeAg seroconversion and HBsAg decline, although the effects of de novo combination therapy with peg‐IFN‐α and NAs on long‐term outcomes remain unclear. Evaluation of baseline and on‐treatment predictors is useful for selecting the patients who are likely to achieve additional benefits. Furthermore, some recent studies have shown that peg‐IFN‐α–based therapy results in better prevention of HBV‐related hepatocellular carcinoma (HCC), especially in high‐risk patients.

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Section: Efficacy Of Peg‐ifnα−containing Regimens In Achieving a Funcmentioning

confidence: 95%

Effects of pegylated interferon‐α based therapies on functional cure and the risk of hepatocellular carcinoma development in patients with chronic hepatitis B

Ren

Huang

2019

Journal of Viral Hepatitis

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“…47 With regard to HBsAg and treatment response, data suggest that lower pretreatment HBsAg values are associated with a greater response to pegylated interferon, and that HBsAg titers may be used as an on-treatment marker for sustained treatment response to this drug. 82 A reduction in HBsAg to 300 IU/mL or less after six months of treatment correlates with a sustained response at 12 months after completion of therapy, defined as anti-HBe seroconversion and HBV DNA less than 2000 IU/mL. 83 Furthermore, patients who do not have a reduction in HBsAg levels at week 12 of pegylated interferon treatment have a low likelihood of sustained response or HBsAg loss.…”

Section: Nucleos(t)ide Analogsmentioning

confidence: 99%

Management of chronic hepatitis B infection

Sundaram

Kowdley

2015

BMJ

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Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it can even reverse liver fibrosis. However, challenges remain regarding optimal timing, as well as the modality and duration of treatment. Currently approved drugs include pegylated interferon and nucleos(t)ide analogs. Nucleos(t)ide analogs are better tolerated and provide excellent viral suppression with a low risk of antiviral resistance, but pegylated interferon offers the benefit of a finite duration of treatment. Monitoring of hepatitis B surface antigen (HBsAg) levels may help to predict the likelihood of response to treatment, particularly for pegylated interferon. Prolonged treatment is usually needed with oral antiviral agents, and relapse is common if treatment is discontinued. New treatments that result in sustained clearance of HBV DNA and the clearance of HBsAg are needed.

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“…Next to the established factors low HBV DNA (<10 8 IU/ml), higher ALT (>2-5 × ULN), and HBV genotypes A and B [12,17] (fig. 2), HBsAg levels at the start of treatment are associated with a better treatment response [24]. However, HBsAg is a better tool for predicting response during treatment with PEG-IFN.…”

Section: Treatment Of Chronic Hepatitis Bmentioning

confidence: 99%

Management of HBV and HBV/HDV-Associated Liver Cirrhosis

Siederdissen

Cornberg

2016

Visc Med

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Background: Chronic hepatitis B virus (HBV) infection and hepatitis delta virus (HDV) co-infection lead to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma (HCC). Methods: We review the current knowledge of the management of HBV mono-infection and HBV/HDV co-infection with a special emphasis on liver cirrhosis. Results: Treatment options for chronic hepatitis B are pegylated interferon (PEG-IFN) alfa and nucleos(t)ide analogues (NUC). PEG-IFN is a finite option to achieve hepatitis B surface antigen loss in compensated cirrhosis. However, this goal is rare. NUC are potent to achieve HBV DNA suppression but long-term treatment is mandatory in most cases. Long-term treatment with NUC can lead to reversion of liver cirrhosis, improve liver function, prevent liver transplantation, and reduces but does not eliminate the risk for development of HCC. Treatment options for hepatitis D are limited to PEG-IFN. Although late relapse is common, treatment with PEG-IFN reduces disease progression. However, new treatments are urgently needed for HDV infection. Conclusion: Early treatment of chronic hepatitis B and D is important to prevent complications of cirrhosis. HCC surveillance remains important in patients with cirrhosis.

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Baseline Hepatitis B Surface Antigen (Hbsag) as Predictor of Sustained Hbsag Loss in Chronic Hepatitis B Patients Treated with Pegylated Interferon-α2A and Adefovir

Abstract: With combination therapy of PEG-IFN and adefovir for 48 weeks, a high rate of HBsAg loss was observed in both HBeAg-positive (11%) and HBeAg-negative (17%) patients 2 years after treatment ended. In HBeAg-negative patients, a low baseline HBsAg level was a strong predictor for HBsAg loss.

Cited by 70 publications

References 31 publications

Effects of pegylated interferon‐α based therapies on functional cure and the risk of hepatocellular carcinoma development in patients with chronic hepatitis B

Effects of pegylated interferon‐α based therapies on functional cure and the risk of hepatocellular carcinoma development in patients with chronic hepatitis B

Management of chronic hepatitis B infection

Management of HBV and HBV/HDV-Associated Liver Cirrhosis

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