Close Monitoring of Hepatitis B Surface Antigen Levels Helps Classify Flares During Peginterferon Therapy and Predicts Treatment Response

Sonneveld, Milan J.; Zoutendijk, Roeland; Flink, Hajo J.; Zwang, L.; Hansen, Bettina E.; Janssen, Harry L.A.

doi:10.1093/cid/cis859

Cited by 34 publications

(23 citation statements)

References 22 publications

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“…[17] Although there were no control groups involving patients without HBsAg loss during PEG-IFN treatment in the current study, others demonstrated that low baseline HBsAg level was the only significant prognostic predictor of HBsAg seroconversion following conventional IFN treatment. [1819] These results suggest that CHB patients with low HBsAg levels should be considered PEG-IFN therapy to achieve HBsAg loss.…”

Section: Discussionmentioning

confidence: 96%

Kinetics of Hepatitis B Surface Antigen Level in Chronic Hepatitis B Patients who Achieved Hepatitis B Surface Antigen Loss during Pegylated Interferon Alpha-2a Treatment

et al. 2017

Chinese Medical Journal

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Background:Hepatitis B surface antigen (HBsAg) loss/seroconversion is considered to be the ideal endpoint of antiviral therapy and the ultimate treatment goal in chronic hepatitis B (CHB). This study aimed to assess the patterns of HBsAg kinetics in CHB patients who achieved HBsAg loss during the treatment of pegylated interferon (PEG-IFN) α-2a.Methods:A total of 150 patients were enrolled, composing of 83 hepatitis B envelope antigen (HBeAg)-positive and 67 HBeAg-negative patients. Patients were treated with PEG-IFN α-2a180 μg/week until HBsAg loss/seroconversion was achieved, which occurred within 96 weeks. Serum hepatitis B virus deoxyribonucleic acid and serological indicators (HBsAg, anti-HBs, HBeAg, and anti-HBe) were determined before and every 3 months during PEG-IFN α-2a treatment. Biochemical markers and peripheral blood neutrophil and platelet counts were tested every 1–3 months.Results:Baseline HBsAg levels were 2.5 ± 1.3 log IU/ml, and decreased rapidly at 12 and 24 weeks by 48.3% and 88.3%, respectively. The mean time to HBsAg loss was 54.2 ± 30.4 weeks, though most patients needed extended treatment and 30.0% of HBsAg loss occurred during 72–96 weeks. Baseline HBsAg levels were significantly higher in HBeAg-positive patients (2.9 ± 1.1 log IU/ml) compared with HBeAg-negative patients (2.0 ± 1.3 log IU/ml; t = 4.733, P < 0.001), but the HBsAg kinetics were similar. Patients who achieved HBsAg loss within 48 weeks had significantly lower baseline HBsAg levels and had more rapid decline of HBsAg at 12 weeks compared to patients who needed extended treatment to achieve HBsAg loss.Conclusions:Patients with lower baseline HBsAg levels and more rapid decline during early treatment with PEG-IFN are more likely to achieve HBsAg loss during 96 weeks of treatment, and extended therapy longer than 48 weeks may be required to achieve HBsAg loss.

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Section: Discussionmentioning

confidence: 96%

Kinetics of Hepatitis B Surface Antigen Level in Chronic Hepatitis B Patients who Achieved Hepatitis B Surface Antigen Loss during Pegylated Interferon Alpha-2a Treatment

et al. 2017

Chinese Medical Journal

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“…A flare was further classified as host‐induced, virus‐induced, or indeterminate based on HBV‐DNA kinetics in the 24 weeks preceding the flare . Host‐induced flares were characterized by an HBV‐DNA decline > 1 log IU/mL within 24 weeks preceding the ALT peak.…”

Section: Methodsmentioning

confidence: 99%

Flares during long‐term entecavir therapy in chronic hepatitis B

Chi

Arends

Reijnders

et al. 2016

J of Gastro and Hepatol

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“…34,44 In contrast, transient ALT flares may indicate some level of immune reconstitution and can be associated with favourable outcomes. 1,45,46 The loss of HBsAg is regarded as the optimal treatment endpoint, termed 'functional cure', but it is only rarely achieved with our current antiviral armamentarium. Spontaneous HBsAg seroreversion with reactivation of the inflammatory liver process after HBsAg loss is rare and may occur in patients with a significant impairment of their immune function.…”

Section: Recommendationsmentioning

confidence: 99%

EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection

Lampertico¹,

Agarwal²,

Berg³

et al. 2017

Journal of Hepatology

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2,771

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Close Monitoring of Hepatitis B Surface Antigen Levels Helps Classify Flares During Peginterferon Therapy and Predicts Treatment Response

Cited by 34 publications

References 22 publications

Kinetics of Hepatitis B Surface Antigen Level in Chronic Hepatitis B Patients who Achieved Hepatitis B Surface Antigen Loss during Pegylated Interferon Alpha-2a Treatment

Kinetics of Hepatitis B Surface Antigen Level in Chronic Hepatitis B Patients who Achieved Hepatitis B Surface Antigen Loss during Pegylated Interferon Alpha-2a Treatment

Flares during long‐term entecavir therapy in chronic hepatitis B

EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection

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