Role of HBsAg decline in patients with chronic hepatitis B HBeAg-negative and E genotype treated with pegylated-interferon

Boglione, Lucio; Cusato, Jessica; Castaldo, Giuseppe; Perri, Giovanni Di; D’Avolio, Antonio

doi:10.1016/j.antiviral.2016.10.011

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…Although other authors have shown a superiority of add‐on therapy to Peg‐IFN or NA monotherapy in terms of serological response, the designs of these previous studies are not comparable to ours and most of them evaluated HBeAg‐positive subjects. Despite the very low response to Peg‐IFN therapy expected in HBeAg‐negative patients, in our cohort, Peg‐IFN add‐on led to a higher proportion of patients achieving an HBsAg level <1000 IU/mL, which is a level associated with high probability of HBsAg clearance and long‐term disease remission . Nonetheless and in accordance with a recent randomized study on a large cohort of HBeAg‐negative patients, we did not show a significant higher proportion of HBsAg loss with the add‐on strategy.…”

Section: Discussionsupporting

confidence: 83%

“…Despite the very low response to Peg-IFN therapy expected in HBeAg-negative patients, in our cohort, Peg-IFN add-on led to a higher proportion of patients achieving an HBsAg level <1000 IU/mL, which is a level associated with high probability of HBsAg clearance and long-term disease remission. 22,[36][37][38][39] Nonetheless and in accordance with a recent randomized study on a large cohort of HBeAg-negative patients, 40 we did not both peripheral blood and the liver. [16][17][18][19] A few contradictory results have been published on the frequency and function of peripheral iNKT cells in HBV infection, [16][17][18][19]44 partially explained by the different methods used to identify iNKT cells.…”

Section: Discussionsupporting

confidence: 66%

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Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study

Cannizzo

Tincati

Binda

et al. 2017

Journal of Viral Hepatitis

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HBV eradication in chronic hepatitis B (CHB) subjects is rarely achieved with either nucleos(t)ide analogues (NA) or pegylated interferon (Peg-IFN), which both have a limited effect in restoring immune responses. Thirty CHB subjects on long-term treatment with tenofovir (TDF) and HBV suppression were enrolled and randomized 1:2 to either receive Peg-IFN-α-2a add-on therapy or continue TDF alone. We studied γδ T and iNKT frequency and function (by flow cytometry) at baseline, at 12 weeks and 12 weeks after the end of treatment. A higher reduction in qHBsAg occurred in the add-on group compared with the NA group at W12 (P = .016) and at W24 (P = .012). A decline of qHBsAg ≥0.5 log at week 24 occurred in 4 of 10 patients in the add-on arm and 1 of 20 in the NA arm, respectively (P = .03). HBsAg loss was seen in 20% of subjects in the add-on group and in none of the NA group. Compared to HBV negative, CHB on TDF showed lower frequency of iNKT (P = .03) and γδ T cells (P = .03) as well as fewer γδ T cells expressing Vδ2 T-cell receptors (P = .005). No changes in unconventional T-cell frequency and function were shown in both add-on and NA patients nor were differences detected between the two treatment groups. We report persistent impairment of unconventional T cells in CHB. Despite a greater qHBsAg decline of add-on patients, our data failed to detect any effect of Peg-IFN treatment on unconventional T cells.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 66%

Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study

Cannizzo

Tincati

Binda

et al. 2017

Journal of Viral Hepatitis

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“…qHBsAg decline was higher in patients with SR undergoing 96 weeks of treatment than in non responder patients (qHBsAg median decrease at 12 weeks: 0.7 log IU/mL in SR and 0.2 log IU/mL in NR). These results confirm the role of qHBsAg at week 12 of treatment as reported in our and other previous studies15 in distinguishing responders from non-responder patients.…”

supporting

confidence: 93%

Extended duration of treatment with peginterferon alfa‐2a in patients with chronic hepatitis B, HBeAg‐negative and E genotype: A retrospective analysis

Boglione

Castaldo

Ghisetti

et al. 2018

Journal of Medical Virology

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An alternative approach in the treatment of chronic hepatitis B (CHB) with pegylated (PEG)-interferon (IFN) is the prolonged course to 96 weeks of therapy, with higher sustained response (SR) than patients treated for 48 weeks. This result was confirmed in patients with CHB and D genotype, while no data are currently available about the prolonged course of PEG-IFN in E genotype. This retrospective analysis reported the role of different treatment duration of PEG-IFN on the SR in patients affected by CHB and E genotype. A total of 86 subjects with CHB and E genotype were considered in this analysis; different treatment durations were: 48 weeks (control group, 41 patients), 72 weeks (25 patients), and 96 weeks (19 patients). Treatment effectiveness was evaluated with sustained response (SR) and serological response. SR was significantly higher in patients who underwent PEG-IFN for 96 weeks in comparison to 48 weeks: 14.6% versus 26.3% (P = 0.016). HBsAg loss rate was 5.3% in patients treated for 96 weeks and 2.4% in the control group. In the multivariate analysis only the 72 and 96 weeks of therapy (OR 2.335, 95% CI 1.550-4.578; P = 0.020 and (OR 3.890, 95% CI 1.991-10.961; P = 0003) were predictive of SR. The extended duration of PEG-IFN course in patients with CHB and genotype E is a promising approach to increase the SR and HBsAg clearance.

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“…The role of quantitative hepatitis B surface antigen (qHBsAg) decline has been previously demonstrated in chronic hepatitis B infection (CHB) during the PEG‐IFN treatment in different HBV genotypes . In CHD, HBsAg kinetics was relevant in responders patients without a significant negative predictive value, as required for a stopping rule at 12 weeks …”

Section: Introductionmentioning

confidence: 99%

Antiviral treatment with pegylated interferon and clinical outcomes in a cohort of immigrants patients affected by hepatitis delta: A retrospective analysis

Boglione

Lupia

Castaldo

et al. 2019

Journal of Medical Virology

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Chronic hepatitis delta (CHD) is the most severe chronic hepatitis, with no satisfactory treatment options and severe clinical outcomes. This infection is frequent in the migrant subjects from endemic areas, especially from Africa and East-Europe. The pegylated (PEG)-interferon α (IFN) is limited by side effects and poor response. In this retrospective analysis, we reported our experience of treatment with PEG-IFN in a cohort of immigrant patients affected by CHD. We evaluated the virological responses are as follows: complete response (CR; clearance of hepatitis B surface antigen [HBsAg] and hepatitis D virus [HDV]-RNA), partial response (PR; HBsAg clearance with HDV-RNA+), and null response (NR; HBsAg and HDV-RNA+). Clinical outcomes were clinical stabilization, disease progression, hepatic decompensation, hepatocellular carcinoma (HCC), death, and liver transplantation. Forty-six patients were included. At the end of treatment (ET), 11 patientsgained a CR (23.9%), 10 were PR (21.7%), and 16 were NR (34.8%). After 1 year, 10 remained with CR (21.7%), after 2 years, 9 (19.5%), and at 3 years, 8 (17.4%).Relapse rate was 2.2%, 4.4%, and 6.5% at year 1, 2, and 3, respectively. Favorable factors were CR at the ET (odds ratio [OR] = 4.559, 95% confidence interval [CI]: 2.219-7.116; P = 0.003), PEG-IFN course greater than 1 (OR = 1.240, 95% CI: 0.998-4.839; P = 0.012), prolonged treatment (OR = 1.276, 95% CI: 0.816-3.108; P = 0.018), quantitative hepatitis B surface antigen (qHBsAg) decline at 12 weeks greater than 0.5 log IU/mL (OR = 4.816,; P < 0.001). The unfavorable factors were cirrhosis (OR = 3.122, 95% CI: 1. 466-4.190; P = 0.012), active hepatitis B virus (OR = 2.334, 95% CI: 1.788-3.992; P = 0.018), NR at ET (OR = 6.998, 95% CI: 5.987-11.404; P < 0001). Treatment of CHD is limited by poor virological response; is NR unfavorable outcomes were unavoidable. No other treatment options were available. K E Y W O R D S clinical outcomes, hepatitis D virus, immigrants, pegylated interferon, quantitative hepatitis B surface antigen J Med Virol. 2019;91:1329-1334.wileyonlinelibrary.com/journal/jmv

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Role of HBsAg decline in patients with chronic hepatitis B HBeAg-negative and E genotype treated with pegylated-interferon

Cited by 10 publications

References 22 publications

Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study

Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study

Extended duration of treatment with peginterferon alfa‐2a in patients with chronic hepatitis B, HBeAg‐negative and E genotype: A retrospective analysis

Antiviral treatment with pegylated interferon and clinical outcomes in a cohort of immigrants patients affected by hepatitis delta: A retrospective analysis

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