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On-treatment prediction of sustained response to peginterferon alfa-2a for HBeAg-negative chronic hepatitis B patients.

TitleOn-treatment prediction of sustained response to peginterferon alfa-2a for HBeAg-negative chronic hepatitis B patients.
Publication TypeJournal Article
Year of Publication2015
AuthorsGoulis, I., Karatapanis S., Akriviadis E., Deutsch M., Dalekos G. N., Raptopoulou-Gigi M., Mimidis K., Germanidis G., Drakoulis C., Triantos C., Zintzaras E., Bakalos G., & Papatheodoridis G.
JournalLiver Int
Volume35
Issue5
Pagination1540-8
Date Published2015 May
ISSN1478-3231
KeywordsAdult, Antiviral Agents, DNA, Viral, Female, Hepatitis B e Antigens, Hepatitis B Surface Antigens, Hepatitis B virus, Hepatitis B, Chronic, Humans, Interferon-alpha, Male, Middle Aged, Polyethylene Glycols, Prognosis, Prospective Studies, Recombinant Proteins
Abstract

BACKGROUND & AIMS: We assessed predictors of response in HBeAg-negative chronic hepatitis B patients treated with peginterferon alfa-2a in routine clinical practice.METHODS: Ninety-five HBeAg-negative patients received peginterferonalfa-2a for 48 weeks and were followed-up for 48 weeks post-treatment. Serum HBsAg and HBV DNA levels were monitored during and after therapy with valid commercial assays. Sustained response (SR) was defined as HBV DNA <2000 IU/ml at study week 96.RESULTS: Twenty-two patients (23%) achieved SR and nine (9.5%) lost HBsAg. HBsAg decline was more profound in patients with SR. HBsAg decline ≥10% from baseline to week 24 was significantly associated with SR [81% (17/21) vs 37% (21/57); Odds ratio: 7.286 (2.162-24.552), P = 0.001]. The PARC rule (no decrease in HBsAg and <2 log drop in HBV DNA at week 12) was evaluated in a subset of 47 patients. Among eight patients who fulfilled the PARC rule, none achieved SR. Of the 39 patients who did not fulfil the PARC rule, 24 (62%) had HBsAg decline of ≥10% at week 24 (12 achieved SR) and 15 (38%) had HBsAg decline of <10% (1 achieved SR; negative predictive value: 93%).CONCLUSIONS: In HBeAg-negative chronic hepatitis B patients treated with peginterferon alfa-2a, HBsAg decline >10% at 24 weeks is significantly associated with SR. The combination of the PARC rule and week 24 decline in HBsAg can identify almost two-thirds of patients who are unlikely to achieve SR. Clinicaltrials.gov identifier: NCT01283074.

DOI10.1111/liv.12725
Alternate JournalLiver Int.
PubMed ID25368957

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