Efficacy of short-term Peg-IFN α-2b treatment in chronic hepatitis B patients with ultra-low HBsAg levels: a retrospective cohort study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101231645 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-422X (Electronic) Linking ISSN: 1743422X NLM ISO Abbreviation: Virol J Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Hepatitis B, Chronic*/drug therapy ; Recombinant Proteins*/therapeutic use ; Recombinant Proteins*/administration & dosage ; Polyethylene Glycols*/therapeutic use ; Polyethylene Glycols*/administration & dosage ; Hepatitis B Surface Antigens*/blood ; Interferon-alpha*/therapeutic use ; Antiviral Agents*/therapeutic use ; Interferon alpha-2*/therapeutic use ; Interferon alpha-2*/administration & dosage; Humans ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Treatment Outcome ; Hepatitis B virus/drug effects ; Young Adult

Purpose: Peginterferon alfa-2b (Peg-IFN α-2b) has demonstrated superior efficacy over nucleos(t)ide analogs (NAs) in the treatment of chronic hepatitis B (CHB), particularly among patients with low levels of hepatitis B surface antigen (HBsAg). This study aims to determine whether patients with ultra-low HBsAg levels (< 200 IU/mL) can achieve significantly higher clinical cure rates with abbreviated courses of Peg-IFN α-2b therapy.
Methods: In this retrospective analysis, CHB patients with HBsAg levels below 200 IU/mL were categorized into a Peg-IFN α-2b group and a control group. The Peg-IFN α-2b group received Peg-IFN α-2b for a minimum of 24 weeks, with the possibility of early discontinuation upon achieving HBsAg clearance, and were followed through week 48. The control group remained untreated for hepatitis B virus (HBV), and was observed for 24 weeks. HBsAg clearance rates were compared between groups. Univariate and multivariate logistic regression analyses were employed to identify factors associated with HBsAg clearance .
Results: By week 24, the HBsAg clearance rate in the Peg-IFN α-2b group was notably 52.1% (38/73), contrasting sharply with the mere 1.3% (1/77) observed in the control group. Within the Peg-IFN α-2b group, a substantial 97.3% (71/73) of patients noted a reduction in HBsAg levels. Besides, the decision to continue or discontinue treatment after the 24-week mark had no significant impact on the HBsAg clearance rate at week 48. Multivariable analysis pinpointed baseline HBsAg levels (OR = 0.984, p = 0.001) and the presence of fatty liver (OR = 5.960, p = 0.033) as independent predictors of HBsAg clearance.
Conclusion: Our findings confirm that a 24-week course of Peg-IFN α-2b yields robust efficacy in CHB patients with ultra-low HBsAg levels. Prolonging treatment beyond the 24-week threshold is deemed unnecessary. Both baseline HBsAg level and the presence of fatty liver emerged as significant predictors for HBsAg clearance.
(© 2024. The Author(s).)

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Keywords: Chronic Hepatitis B; Clinical cure; Fatty liver; Hepatitis B Surface antigen; Peginterferon alfa-2b

0 (Recombinant Proteins)
3WJQ0SDW1A (Polyethylene Glycols)
0 (Hepatitis B Surface Antigens)
0 (Interferon-alpha)
0 (Antiviral Agents)
G8RGG88B68 (peginterferon alfa-2b)
0 (Interferon alpha-2)

Date Created: 20240928 Date Completed: 20240928 Latest Revision: 20241007

20241008

PMC11428405

10.1186/s12985-024-02512-w

39334422