Higher efficacy of pegylated interferon‐α2b add‐on therapy in hepatitis B envelope antigen‐positive chronic hepatitis B patients on tenofovir monotherapy

Jindal, Ankur; Vyas, Ashish Kumar; Kumar, Devesh; Kumar, Guresh; Sharma, Manoj Kumar; Sarin, Shiv Kumar

doi:10.1111/hepr.13049

Cited by 14 publications

(7 citation statements)

References 15 publications

(27 reference statements)

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“…Therefore, not all patients can get a good response to IFN treatment. Recently, more and more clinical trials have attempted to investigate whether combination therapy with IFN and NUCs can increase response rates and provide a treatment option with limited duration of treatment 30–32. The results of this study suggest that IFN+TDF can increase virological response rate and HBsAg serological response rate, especially for those patients with lower baseline viral load, younger age, and higher degree of inflammation.…”

Section: Discussionmentioning

confidence: 76%

<p>Comparison of pegylated interferon monotherapy and de novo pegylated interferon plus tenofovir combination therapy in patients with chronic hepatitis B</p>

Zheng¹,

Yan²,

Zeng³

et al. 2019

IDR

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Background and aim: We aimed to evaluate the effectiveness of pegylated interferon (Peg-IFN) monotherapy (IFN group) and combination therapy with tenofovir (TDF) and Peg-IFN (IFN+TDF group) in chronic hepatitis B (CHB) patients. Patients and methods: Data of 143 CHB patients were analyzed in this study. All patients enrolled received liver biopsy. Virologic responses were defined as hepatitis B virus (HBV) DNA <100 IU/mL, biochemical responses were defined as normalization of alanine aminotransferse (ALT) levels, and HBeAg serological response was defined as HBeAg loss or HBeAg seroconversion to HBeAb. HBsAg serological response was defined as HBsAg loss or HBsAg seroconversion to HBsAb. Results: We observed that a total of 16.7% (11/66) and 33.8% (26/77) patients in IFN and IFN+TDF group achieved complete viral suppression after 48 weeks treatment ( P =0.02). Although HBeAg levels in CHB patients in the IFN+TDF group decreased more rapidly during the 48-week treatment, we did not observe significant differences in HBeAg serological loss or seroconversion rates between the two groups at 24 and 48 weeks. HBsAg loss was observed in 13.0% (10/77) of CHB patients in the IFN+TDF group at 48 weeks, compared with only 3% (2/66) patients in the IFN group ( P =0.032). No significant difference was observed in HBsAg seroconversion rate between the two groups during 48-week treatment. The biochemical response rate was also significantly higher in the IFN+TDF group than that in the IFN group at week 48 ( P =0.015). Multivariate logistic analysis showed that IFN+TDF treatment (OR=4.41, P =0.003), severe baseline hepatic inflammation (OR=4.16, P <0.001), and lower baseline serum HBV DNA levels (OR=0.98, P =0.03) were strong predictors for the virological response. Younger age (OR=0.89, P =0.01), higher baseline ALT level (OR=1.01, P =0.038), and lower baseline HBeAg level (OR=0.99, P =0.008) were independent predictors for HBeAg sero-response after 48 weeks treatment. While only severe liver fibrosis (OR=1.69, P =0.028) and lower baseline HBsAg level (OR=0.22, P =0.005) were independent factors associated with HBsAg sero-response after 48 weeks treatment. Conclusion: Peg-IFN combined with TDF may increase the virological response rate, biochemical response rate, and HBsAg loss rate in patients with CHB infection. The combination treatment is more suitable for those patients who are likely to respond to the treatment.

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Section: Discussionmentioning

confidence: 76%

<p>Comparison of pegylated interferon monotherapy and de novo pegylated interferon plus tenofovir combination therapy in patients with chronic hepatitis B</p>

Zheng¹,

Yan²,

Zeng³

et al. 2019

IDR

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“…We previously reported that switching to pegylated interferon (PEG‐IFN) after long‐term NA administration can reduce HBsAg levels . Some studies have also shown the HBsAg‐reducing effect of PEG‐IFN . However, PEG‐IFN treatment is difficult to administer to many patients due to its side effects.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B surface antigen reduction as a result of switching from long‐term entecavir administration to tenofovir

et al. 2019

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Background and Aim Loss of hepatitis B surface antigen (HBsAg) is an important goal in the treatment of chronic hepatitis B. We investigated whether switching from long‐term entecavir (ETV) administration to tenofovir (TFV) (tenofovir alafenamide [TAF] or tenofovir disoproxil fumarate [TDF]) could contribute to the reduction of HBsAg levels. Methods The degree of HBsAg reduction by 48 weeks in 30 patients following switching from ETV to TFV was compared with results from 147 patients who continued ETV as a control. Results TFV group switched to TFV after mean 6.79 years of ETV administration. HBV‐DNA levels remained below 1.0 log IU/mL in all cases in both groups during 48 weeks. Median HBsAg reduction at 48 weeks was 0.075 (−0.05 to 0.38) log/IU/mL in the TFV switch group, and 0.070 (−0.28 to 0.50) in the ETV continuation group, which was not statistically significant (p = 0.5). In a subgroup of hepatitis B e antigen negative patients whose HBsAg had not been reduced (HBsAg reduction ≤0 log IU/mL) in the 48 weeks prior to entry into the study, HBsAg reduction was significantly higher in the TFV switch group than in the ETV continuation group (0.15 [0.07–0.135] in TFV, 0.09 [−0.14 to 0.25] log IU/mL in ETV, p = 0.04). Conclusion Although HBsAg reduction is equivalent with ETV continuation and switching to TFV in all patients at 48 weeks, switching from ETV to TFV could provide an alternative therapeutic strategy toward HBsAg elimination in a specific subpopulation of patients.

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“…4 Pretreatment HBsAg level and hepatitis B genotype are important predictors of viral relapse in CHB patients undergoing pegylated IFN treatment. 5,6 Data on these factors were not provided in the analysis.…”

Section: Muddle and Mechanism Of Hepatitis B Surface Antigen Serocleamentioning

confidence: 99%

Muddle and Mechanism of Hepatitis B Surface Antigen Seroclearance

Vyas

Jindal

2019

Clinical Gastroenterology and Hepatology

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Higher efficacy of pegylated interferon‐α2b add‐on therapy in hepatitis B envelope antigen‐positive chronic hepatitis B patients on tenofovir monotherapy

Abstract: Twenty-four weeks of Peg-IFNα2b as an add-on sequential regimen to tenofovir is safe and resulted in greater loss of HBeAg and HBsAg compared to tenofovir monotherapy in selected HBeAg-positive patients. Viral load reduction followed by immune modulation is a potentially useful approach.

Cited by 14 publications

References 15 publications

<p>Comparison of pegylated interferon monotherapy and de novo pegylated interferon plus tenofovir combination therapy in patients with chronic hepatitis B</p>

<p>Comparison of pegylated interferon monotherapy and de novo pegylated interferon plus tenofovir combination therapy in patients with chronic hepatitis B</p>

Hepatitis B surface antigen reduction as a result of switching from long‐term entecavir administration to tenofovir

Muddle and Mechanism of Hepatitis B Surface Antigen Seroclearance

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