title: Long-term effect of interferon plus ribavirin on hepatitis B surface antigen seroclearance in patients dually infected with hepatitis B and C viruses.
abstract: BACKGROUND
  Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg) seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV), but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients.
  
  
  RESULTS
  Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5%) patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1) years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR), 95% confidence intervals (CI) of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745). Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss.
  
  
  CONCLUSIONS
  We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance.
authors.affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Yeh
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Hung
authors.forename: Jee-Fu
authors.initials: JF
authors.lastname: Huang
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chia-Yen
authors.initials: CY
authors.lastname: Dai
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Zu-Yau
authors.initials: ZY
authors.lastname: Lin
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
mesh_terms: D004279:DNA, Viral / Q000032:analysis; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology*; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology*; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha; D012254:Ribavirin