Pegylated interferon alfa for chronic hepatitis B: systematic review and meta‐analysis

Abstract

SUMMARY. Conventional interferon alfa and nucleos(t)ide analogues, such as lamivudine, are frequently used for chronic hepatitis B (CHB) treatment, but are associated with adverse effects and viral resistance. Here we performed a systematic review and meta-analysis evaluating all studies of pegylated interferon alfa (PEG-IFNa) treatment in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with CHB. We searched electronic databases -PubMed, EMBASE, Cochrane Library and LILACS -for randomized controlled trials evaluating PEGIFNa therapy between 1999 and September 2014. Virological response was the primary outcome. We identified 14 studies involving 2829 patients. Our analysis revealed that PEG-IFNa + lamivudine combination therapy produced better virological and biochemical responses than PEGIFNa monotherapy in HBeAg-positive and HBeAg-negative patients at the end of treatment. PEG-IFNa + adefovir dipivoxil achieved better seroconversion rate than PEG-IFNa in HBeAg-positive patients at the end of treatment. The present findings demonstrated a beneficial response rate following PEG-IFNa combination therapy with nucelos(t)ides among HBeAg-positive and HBeAg-negative patients with CHB. Further trials are needed to investigate simultaneous and sequential therapy strategies.

Exosomal Interferon‐Induced Transmembrane Protein 2 Transmitted to Dendritic Cells Inhibits Interferon Alpha Pathway Activation and Blocks Anti–Hepatitis B Virus Efficacy of Exogenous Interferon Alpha

“…However, the therapeutic outcome of Peg‐IFNα on CHB patients is still suboptimal. Previous studies reported that sustained virological response rates (HBV DNA <2,000 IU/mL) were only 30% in hepatitis B e antigen (HBeAg)‐positive and 43% in HBeAg‐negative patients at 24 weeks after completion of a 48‐week Peg‐IFNα treatment . Improving the response to IFNα‐based treatment remains an essential issue in the management of CHB patients.…”

Intensification with pegylated interferon during treatment with tenofovir in HIV–hepatitis B virus co‐infected patients

“…13 Combining PegIFN with a potent NA has shown a favourable impact on HBeAg seroclearance and HBsAg seroclearance. 14,15 While more recent clinical trials in HBeAg-positive patients have concluded that adding or switching to PegIFN from an already existing potent NA-based regimen could increase rates of HBeAg seroclearance and HBeAg seroconversion, even after completing PegIFN. 16,17 Despite these encouraging data, it remains unknown whether such a treatment strategy would be beneficial to HIV-HBV co-infected patients, for whom interferon-based treatments are generally less successful.…”

“…In HBV mono‐infection, treatment with pegylated interferon (PegIFN) has demonstrated higher rates of HBeAg seroconversion compared to nucleoside/nucleotide analogues (NA) with lower antiviral potency . Combining PegIFN with a potent NA has shown a favourable impact on HBeAg seroclearance and HBsAg seroclearance . While more recent clinical trials in HBeAg‐positive patients have concluded that adding or switching to PegIFN from an already existing potent NA‐based regimen could increase rates of HBeAg seroclearance and HBeAg seroconversion, even after completing PegIFN .…”

Avaliação dos desfechos virológicos e de adesão ao tratamento antiviral em pacientes portadores de hepatite B crônica

“…Entretanto, sete agentes terapêuticos encontram-se aprovados para uso na hepatite B crônica na maioria dos países do mundo: adefovir, entecavir, lamivudina, telbivudina, tenofovir, interferon-alfa e interferon peguilado (52)(53)(54)(55)(56)(57)(58)(59) . A tabela 2 mostra os principais análogos de nucleos(t)ídeos aprovados.…”

“…A descontinuação do tratamento antiviral geralmente leva à perda de controle viral e desenvolvimento de variantes de resistência antiviral (52,96,97) .…”