Serum HBsAg quantification to predict response to peginterferon therapy of e antigen positive chronic hepatitis B.
BACKGROUND
On-treatment predictors of response to peginterferon can guide individualization of therapy in chronic hepatitis B virus infection.


OBJECTIVE
To investigate the use of serum hepatitis B surface antigen quantification to predict sustained response.


METHODS
Hepatitis B e antigen-positive chronic hepatitis B patients who received peginterferon for 32-48 weeks with or without lamivudine combination were studied. Sustained response was defined as hepatitis B e antigen seroconversion and chronic hepatitis B virus DNA <10 000 copies/mL until 12 months post-treatment.


RESULTS
Twenty-one of 92 (23%) patients achieved sustained response. At month 6, the area under receiver operating characteristics curve for hepatitis B surface antigen to predict sustained response was 0.77 (95% confidence interval 0.65-0.89, P < 0.001). An hepatitis B surface antigen cutoff at 300 IU/mL at month 6 could give the maximum combination of sensitivity (62%) and specificity (89%) to predict sustained response. Nine of 21 (43%) sustained responders vs. 9 of 71 (13%) nonsustained responders had >1 log hepatitis B surface antigen reduction at month 6 (P < 0.001). Combined hepatitis B surface antigen ≤ 300 IU/mL and >1 log reduction at month 6 had sensitivity, specificity, positive and negative predictive values of 43%, 96%, 75% and 85% to predict sustained response, respectively.


CONCLUSIONS
On-treatment serum hepatitis B surface antigen can predict response to peginterferon therapy in chronic hepatitis B.
Department of Medicine and Therapeutics, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. hlychan@cuhk.edu.hk
H L-Y
HL
Chan
V W-S
VW
Wong
A M-L
AM
Chim
H-Y
HY
Chan
G L-H
GL
Wong
J J-Y
JJ
Sung
D000328:Adult; D000998:Antiviral Agents / Q000276:immunology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012372:ROC Curve; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D019259:Lamivudine; D011092:Polyethylene Glycols; D007372:Interferons