title: Early serum hepatitis B virus large surface protein level: a stronger predictor of virological response to peginterferon alfa-2a than that to entecavir in HBeAg-positive patients with chronic hepatitis B.
abstract: BACKGROUND
  The response rate to antiviral therapy varies greatly among individuals, and its prediction is still very challenging.
  
  
  OBJECTIVE
  To evaluate the usefulness of serum hepatitis B virus large surface protein (LHBs) levels compared with HBsAg in prediction of the antiviral treatment effect.
  
  
  METHODS
  Quantification of LHBs, HBsAg and HBV DNA was carried out at baseline and during antiviral therapy (weeks 4, 12, 24, 36 and 48) in HBeAg-positive patients treated with peginterferon alfa-2a (n = 21) or entecavir (n = 41).
  
  
  RESULTS
  The serum LHBs concentration was correlated positively with HBV DNA and HBsAg (r = 0.635 and 0.588, respectively). LHBs and HBV DNA levels decreased significantly in a biphasic manner and HBsAg level tended to decrease slowly in both treatment groups. In peginterferon alfa-2a group, the cutoff of 88.46 ng/ml in serum LHBs at week 4 gave the best AUC ( = 0.96) with positive and negative predictive values of 88.9% and 100%, in association with virological response (VR). Serum LHBs level at week 4 also showed an association with VR in entecavir group (AUC 0.78). The predictive model incorporating LHBs, HBsAg and HBV DNA could discriminate VR at baseline (AUC 0.79) and showed an association with serological response (SR) at week 12 (AUC 0.80) in peginterferon alfa-2a group.
  
  
  CONCLUSIONS
  On-treatment quantification of serum LHBs may be a more useful parameter for predicting VR in patients on peginterferon alfa-2a than those on entecavir. Combining LHBs, HBsAg and HBV DNA can predict VR and SR more effectively and earlier.
authors: Department of Infectious Diseases, Institute of Infectious & Respiratory Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors: Xuejuan
authors: X
authors: Zhu
authors: Qiming
authors: Q
authors: Gong
authors: Demin
authors: D
authors: Yu
authors: Donghua
authors: D
authors: Zhang
authors: Leilei
authors: L
authors: Gu
authors: Yue
authors: Y
authors: Han
authors: Jia
authors: J
authors: Chen
authors: Yan
authors: Y
authors: Zhang
authors: Xinxin
authors: X
authors: Zhang
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000276:immunology / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood* / Q000276:immunology; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000276:immunology / Q000627:therapeutic use; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000097:blood* / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology / Q000378:metabolism*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000276:immunology / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000276:immunology / Q000627:therapeutic use; D044967:Serum / Q000276:immunology / Q000821:virology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; C100416:peginterferon alfa-2a