title: Response-guided therapy of regimens based on PEG-interferon for chronic hepatitis B using on-treatment hepatitis B surface antigen quantification: a meta-analysis.
abstract: OBJECTIVE
  The efficacy of on-treatment hepatitis B surface antigen (HBsAg) levels in guiding pegylated interferon (PEG-IFN) therapy for chronic hepatitis B (CHB) infections is still controversial. The aim of this study is to quantitatively evaluate the efficacy of on-treatment HBsAg levels as a response-guided therapy strategy to guide PEG-IFN-based therapies for CHB.
  
  
  METHODS
  We searched PUBMED, EMBASE, and the Cochrane Library (1997-2013) for clinical research involving HBsAg quantification, and the response to PEG-IFN-based therapy. Pooled effect of HBsAg levels on guiding PEG-IFN-based therapies for CHB was evaluated using fixed-effects or random-effects model.
  
  
  RESULTS
  From 13 studies (n = 1493 patients), patients with optimal on-treatment HBsAg levels were found to have a greater chance of attaining a response (RR 5.17, 95 % CI 3.75-7.11, p < 0.00001), and the pooled total response rate was 54 % (95 % CI 44-63 %). At week 12, patients without optimal on-treatment HBsAg levels had hardly achieved a response (the early non-response rate: 99 %, 95 % CI 98-100 %). At 24 weeks, the response rate increased to 79 % in HBeAg-negative patients.
  
  
  CONCLUSIONS
  This meta-analysis suggested that on-treatment HBsAg quantification is effective in guiding the therapy of PEG-IFN in CHB infections, especially in HBeAg-negative patients.
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China.|Department of Infectious Diseases, The Guizhou Province People's Hospital, Guiyang, Guizhou Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wei
authors.affiliation: Department of Gastroenterology, The Central Hospital of Zhoukou, Zhoukou, Henan Province, China.
authors.forename: Jun-Ying
authors.initials: JY
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China.
authors.forename: Huai-Dong
authors.initials: HD
authors.lastname: Hu
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ren
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Second Affiliated Hospital of Chongqing Medical University, LinjiangRoad#76, Yuzhong District, Chongqing, 400010, China. hp_cq@163.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Hu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D004337:Drug Carriers; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004337:Drug Carriers; D006514:Hepatitis B Surface Antigens; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a
keywords: Antiviral treatment; HBV DNA; Nucleot(s)ide analogs; Sero conversion