title: [Efficacy of pegylated-interferon alpha-2a treatment in patients with HBeAg-positive chronic hepatitis B and partial viral response to nucleoside analogue therapy].
abstract: OBJECTIVE
  To investigate the efficacy and related factors of pegylated-interferon alpha-2a (PEG-IFN-2a) treatment in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) who achieved partial viral response with nucleoside analogue (NA) therapy.
  
  
  METHODS
  Patients with HBeAg-positive CHB and partial viral response to NA treatment were administered a PEG-IFN-2a therapy regimen of 180 g subcutaneous injection once weekly for a personlized duration of time. The existing NA therapy was continued in combination with the new PEG-IFN-2a treatment for 12 weeks. Measurements of serum HBV DNA load, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HBeAg and hepatitis B e antibody (anti-HBe) were taken at baseline (prior to addition of the PEG-IFN-2a therapy) and every 3 months afterwards.For determining response to treatment, primary efficacy was defined as undetectable HBsAg and seroconversion, and secondary efficacy was defined as HBsAg less than 10 IU/mL and HBeAg seroconversion.Statistical analysis was carried out using SPSS statistical software.
  
  
  RESULTS
  A total of 81 consecutive patients with an average of 12.0 months (range: 6.0-24.0 months) of NA therapy were included in the study and received an average of 19.6 months (range: 15.5-33.3 months) of PEG-IFN-2a treatment. At the end of PEG-IFN-2a therapy, 7 (8.6%) of the patients achieved undetectable HBsAg and seroconversion, and 14 (17.3%) showed HBsAg less than 10IU/mL. In addition, 40.7% achieved undetectable HBeAg and seroconversion, a rate that was slightly higher than that (38.3%) seen in treatment-naive patients who received PEG-IFN-2a. Statistical analyses suggest that baseline level of HBsAg at less than 1500 IU/mL may predict end of PEG-IFN-2a treatment response for HBsAg less than 10 IU/mL, as evidenced by the area under the curve measure of 0.747, sensitivity measure of 87.3%, specificity measure of 33.3%, positive predictive value of 82.1% and negative predictive value of 42.8%.
  
  
  CONCLUSIONS
  Patients with HBeAg-positive CHB and partial viral response to NA therapy can achieve undetectable HBsAg and HBeAg seroconversion after switching to PEG-IFN-2a treatment. Baseline HBsAg level may be predictive of response to this therapeutic strategy.
authors.affiliation: Medical Department 2 of Liver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Li
authors.forename: Lei-Ping
authors.initials: LP
authors.lastname: Hu
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.forename: Yao
authors.initials: Y
authors.lastname: Lu
authors.forename: Ge
authors.initials: G
authors.lastname: Shen
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Wu
authors.forename: Min
authors.initials: M
authors.lastname: Chang
authors.forename: Cai-Qin
authors.initials: CQ
authors.lastname: Mu
authors.forename: Yun-Zhong
authors.initials: YZ
authors.lastname: Wu
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.forename: Shu-Jing
authors.initials: SJ
authors.lastname: Song
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Zhang
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Hua
authors.forename: Yao
authors.initials: Y
authors.lastname: Xie
authors.forename: Jun
authors.initials: J
authors.lastname: Cheng
authors.forename: Dao-Zhen
authors.initials: DZ
authors.lastname: Xu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D009705:Nucleosides / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D009705:Nucleosides; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a