Sustained Off Therapy Response after Peglyated Interferon Favors Functional Cure and No Disease Progression in Chronic Hepatitis B
Soon Kyu Lee 1 2 , Jung Hyun Kwon 3 2 , Sung Won Lee 4 2 , Jeong Won Jang 1 2 , Heechul Nam 1 2 , Kyoung Won Baik 3 2 , Sun Hong Yoo 3 2 , Soon Woo Nam 3 2 , Pil Soo Sung 1 2 , Si Hyun Bae 5 2 , Jong Young Choi 1 2 , Seung Kew Yoon 1 2
Affiliations
Affiliations
1
Division of Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea.
2
The Catholic University Liver Research Center, The Catholic University of Korea.
3
Division of Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea.
4
Division of Hepatology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea.
5
Division of Hepatology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea.
PMID: 33043567 DOI: 10.1111/liv.14701
Abstract
Background & aims: ucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients reduces liver-related mortality. However, long-term outcomes after pegylated interferon (PEG-IFN) therapy remain to be elucidated. Therefore, we aimed to investigate the long-term effectiveness and clinical outcomes of PEG-IFN therapy.
Methods: A total of 190 patients treated with PEG-IFN for CHB or compensated liver cirrhosis were consecutively enrolled between 2005 and 2014, and 122 patients who completed the treatment were analyzed. The initial response was assessed at 6 months post-treatment and defined as achieving both <2,000 IU/mL HBV DNA and HBeAg loss or seroconversion in the HBeAg-positive group, and <2,000 IU/mL HBV DNA in the HBeAg-negative group. The rates of HBsAg loss, disease progression to cirrhosis or HCC, and sustained off-therapy response, defined as not requiring further NAs due to low viremia and liver enzymes, were analyzed.
Results: The median follow-up period was 7.2 years. Forty-three (35.2%) patients achieved an initial response and 53 patients (43.4%) achieved a sustained response. Initial responders displayed higher rates of sustained response than noninitial responders (69.6% vs. 32.5%, P<0.001). A higher rate of HBsAg loss was observed in patients who achieved a sustained response than in non-sustained responders (16.2% vs. 2.5%, P=0.01). Disease progression to cirrhosis or HCC was observed in 8 patients (6.6%) who were nonsustained responders.
Conclusions: During long-term follow-up after PEG-IFN treatment, nearly half of patients achieved sustained response without the need of further NA and these patients displayed favorable outcomes, including HBsAg loss and no disease progression.
方法:2005年至2014年间,共190例接受PEG-IFN治疗CHB或代偿性肝硬化的患者入选,并对122例完成治疗的患者进行了分析。初始反应在治疗后6个月进行评估,定义为在HBeAg阳性组中达到<2,000 IU / mL HBV DNA和HBeAg丧失或血清转化,在HBeAg阴性组中达到2,000 IU / mL HBV DNA。分析了HBsAg丢失率,疾病发展为肝硬化或HCC以及持续的非治疗反应率,定义为由于低病毒血症和肝酶不需要进一步的NAs。