1847
High Rate of HBsAg Loss After Peginterferon Based
Combination Treatment for Chronic Hepatitis B Patients:
Results After 5 Years of Follow-up
Femke Stelma1, Meike H. van der Ree1, Martine W. Peters1, Louis
Jansen1, Annikki de Niet1, Harry L. Janssen2,3, Hans L. Zaaijer4, R
B. Takkenberg4, Hendrik W. Reesink4; 1Department of Gastroenterology
and Hepatology, Academic Medical Center, Amsterdam,
Netherlands; 2Department of Gastroenterology and Hepatology,
Erasmus Medical Centre, Amsterdam, Netherlands; 3Toronto Centre
for Liver Disease, Toronto Western & General Hospital, University
Health Network, Toronto, ON, Canada; 4Department of
Virology, Academic Medical Center, Amsterdam, Netherlands
Background and aims Combining peginterferon alfa-2a
(pegIFN) with a nucleotide analogue can result in higher rates
of HBsAg loss than either therapy given alone. However, the
long term sustainability of HBsAg loss upon such treatment
regimens is not well known. In this study we investigated the
5-year outcome in chronic hepatitis B (CHB) patients treated
with pegIFN and adefovir combination therapy. Methods In
the initial study, 92 CHB patients were included. At baseline,
patients (44 HBeAg positive, 48 HBeAg negative) had HBV
DNA levels > 100,000 c/mL (17,182 IU/mL) and elevated
ALT levels or histological signs of active hepatitis. Patients were
treated for 48 weeks with pegIFN alfa-2a 180 mcg/week and
10 mg adefovir dipivoxil daily. During long term follow-up, routine
check-up and laboratory testing was performed yearly. At
year 5 of follow-up 70 (32 HBeAg positive, 38 HBeAg negative)
patients were still included. Results At year 5, 19% (6/32)
of HBeAg positive patients and 16% (6/38) of HBeAg negative
patients had HBsAg loss, no sero-reversion was observed.
The 5-year cumulative Kaplan-Meier estimate for HBsAg loss
was 17.2% for HBeAg positive patients and 19.3% for HBeAg
negative patients (Figure). Of the 16 patients who lost HBsAg,
12 patients reached end of follow-up; 2 died and 2 were lost
to follow up. 14/16 patients who lost HBsAg had positive anti-
HBs antibodies (>10 IU/L). At the end of 5 years follow-up,
2/32 HBeAg positive patients and 5/38 HBeAg negative
patients had a durable combined response (HBV DNA <2,000
IU/mL with ALT normalization and HBeAg negativity excluding
retreated patients and patients with HBsAg loss). The cumulative
Kaplan-Meier estimate for retreatment was 60% of patients
at year 5. Conclusion At year 5 of follow-up, 17-19% of CHB
patients treated with pegIFN based combination therapy had
HBsAg loss and 88% of these had developed anti-HBs antibodies.
PegIFN based combination treatment can lead to a durable
functional cure in patients with chronic hepatitis B. 作者: StephenW 时间: 2016-11-1 19:28
AASLD2016 [1847扰素联合治疗后高HBsAg损失率5年随访结果
聚乙二醇干扰素后高HBsAg损失率高
慢性乙型肝炎患者的联合治疗:
5年随访结果
Femke Stelma1,Meike H.van der Ree1,Martine W. Peters1,Louis
Jansen1,Annikki de Niet1,Harry L.Janssen2,3,Hans L.Zaaijer4,R
B. Takkenberg4,Hendrik W. Reesink4;消化内科
和Hepatology,Academic Medical Center,Amsterdam,
荷兰; 2胃肠病与肝病,
Erasmus医疗中心,荷兰阿姆斯特丹; 3多伦多中心
为肝病,多伦多西部和总医院,大学
健康网络,多伦多,ON,加拿大; 4
Virology,Academic Medical Center,Amsterdam,Netherlands