Background and aims: HBsAg clearance is the closest cure outcome in hepatitis B. The goal ... Background and aims: HBsAg clearance is the closest cure outcome in hepatitis B. The goal of this study is to investigate clinical features in chronic hepatitis B patients achieving seroconversion of HBsAg after treatment with interferon alpha and a nucleos(t)ide analogue. Methods: This retrospective study enrolled thirty-eight chronic hepatitis B patients treated with interferon alpha plus a nucleos(t)ide analogue and achieved HBsAg seroconversion during the period from June 2001 to May 2009. Clinical and laboratory data of the patients were collected before and after treatment every 3 months. All patients with HBsAg seroconversion in this study were followed up at least 12 months post-treatment. Results: 38 out of 142 patients achieved HBsAg sercovertion after treatment with interferon alpha and a nucleos(t)tid analogue for prolonged period of time(medium 31 months). The median time to HBeAg seroconversion and to HBsAg seroconversion was 19.5 months (range 3-60 months) and 25.5 months (range 9-63 months) respectively. Thirty-six patients (95%) sustained HBsAg seroconversion during the post-treatment follow-up. Three different HBsAg response patterns were observed with classical model accounting for 57.9% (22/38 cases), simultaneous transition mode accounting for 23.7% (9/38 cases), and HBsAg prior transition model accounting for 18.4% (7/38 cases). Conclusions: Extended treatment with interferon alpha in combination with a nucleos(t)ide analogue in patients with HBeAg-positive appears to be a promising approach for achieving high rate of HBsAg clearance - the closest outcome to cure.
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