High rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients responding to interferon: a long-term follow-up study.
OBJECTIVE
To assess the HBsAg seroconversion rate and its impact on the long-term outcome in chronic hepatitis B patients treated with conventional interferon, and to analyze the serum HBsAg concentration prior to seroconversion.


METHODS
Ninety-seven HBeAg-positive patients were retrospectively evaluated. Sustained virological response (SVR) was defined as HBeAg seroconversion and undetectable serum HBV-DNA 48 weeks after treatment discontinuation. HBsAg level was assessed at yearly intervals until seroconversion in SVRs.


RESULTS
Twenty-five patients (26%) achieved SVR. By multivariate analysis, SVR was associated with low serum HBV DNA level and severe liver fibrosis. During a median follow-up of 14 years (range, 5-20 years), 28 patients (29%) developed HBsAg seroconversion including 16 SVRs (64%) and 12 non-SVRs (16%), p < 0.001. HBsAg quantification showed a major decrease (median = 46%, range = 19-100%) in the first year after interferon starting in SVR patients. Six patients developed hepatocellular carcinoma, none of them had undergone HBsAg seroconversion. Liver fibrosis improved in 70% of patients with HBsAg seroconversion compared to 30% of those without HBsAg seroconversion (p < 0.01).


CONCLUSIONS
HBsAg seroconversion is achieved with a high steady rate in patients responding to interferon, and associated with excellent outcome. Prospective studies are needed to clarify the utility of on-treatment quantitative serum HBsAg in interferon-based therapy.
Moucari
Rami
R
AP-HP, Hôpital Beaujon, Service d'Hépatologie, 100 Boulevard du Général Leclerc, 92100 Clichy, France.
Korevaar
Anneke
A
Lada
Olivier
O
Martinot-Peignoux
Michelle
M
Boyer
Nathalie
N
Mackiewicz
Vincent
V
Dauvergne
Agnes
A
Cardoso
Ana C
AC
Asselah
Tarik
T
Nicolas-Chanoine
Marie-Hélène
MH
Vidaud
Michel
M
Valla
Dominique
D
Bedossa
Pierre
P
Marcellin
Patrick
P
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D007372:Interferons