title: Hepatitis B surface antigen reduction by switching from long-term nucleoside/nucleotide analogue administration to pegylated interferon.
abstract: Hepatitis B surface antigen (HBsAg) reduction during nucleoside/nucleotide analogue (NA) therapy is slow and an alternative strategy for patients receiving ongoing NA to facilitate HBsAg reduction is required. We investigated whether switching to pegylated interferon (PEG-IFN) after long-term NA administration enhances HBsAg reduction. Forty-nine patients who switched from long-term NA to 48 weeks of PEG-IFN alfa-2a were studied. The mean duration of previous NA was 48 months (sequential group). A total of 147 patients who continued NA and matched for baseline characteristics were analysed for comparison (NA continuation group). The treatment response was defined as HBsAg reduction ≥1.0 logIU/mL at the end of PEG-IFN. HBsAg reduction at week 48 was 0.81±1.1 logIU/mL in the sequential group, which was significantly higher than that in the NA continuation group (0.11±0.3 logIU/mL, P < .001). The treatment response was achieved in 29% and 2% of the sequential group and NA continuation group (P < .001), and the odds ratio of sequential therapy for the treatment response was 19 compared with the NA continuation (P < .001). In patients tested positive for hepatitis B e antigen (HBeAg), HBeAg seroconversion was higher in the sequential group (44% vs 8%, P < .001). In HBeAg-negative patients, only patients in the sequential group achieved HBsAg loss. No patient needed to resume NA administration because of HBV DNA increase accompanied by alanine aminotransferase flares. In summary, sequential therapy with PEG-IFN after long-term NA enhances the reduction of HBsAg and may represent a treatment option to promote HBsAg loss.
authors.affiliation: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
authors.forename: N
authors.identifier: 0000-0003-4634-6616
authors.initials: N
authors.lastname: Tamaki
authors.affiliation: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kurosaki
authors.affiliation: Department of Gastroenterology and Hepatology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kusakabe
authors.affiliation: Department of Gastroenterology and Hepatology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Orito
authors.affiliation: Department of Gastroenterology and Hepatology, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Joko
authors.affiliation: Department of Gastroenterology and Hepatology, Ise Red Cross Hospital, Ise, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology and Hepatology, Matsue Red Cross Hospital, Matsue, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Uchida
authors.affiliation: Department of Gastroenterology and Hepatology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Hasebe
authors.affiliation: Department of Hepatitis Control, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Asahina
authors.affiliation: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Izumi
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood; D057915:Drug Substitution / Q000379:methods*; D005260:Female; 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 / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000008:administration & dosage*; D009711:Nucleotides / Q000008:administration & dosage*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D009705:Nucleosides; D009711:Nucleotides; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a
keywords: HBsAg; PEG-IFN; chronic hepatitis B; sequential therapy