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Hepatitis B e antigen levels and response to peginterferon: Influence of precore and basal core promoter mutants
Original Research Article
Pages 312-317
Milan J. Sonneveld, Vincent Rijckborst, Louwerens Zwang, Stefan Zeuzem, E. Jenny Heathcote, Krzysztof Simon, Roeland Zoutendijk, Ulus S. Akarca, Suzan D. Pas, Bettina E. Hansen, Harry L.A. Janssen
Abstract
Hepatitis B e antigen (HBeAg) levels may predict response to peginterferon (PEG-IFN) but are also influenced by presence of precore (PC) and core promoter (BCP) mutants.
HBeAg was measured in 214 patients treated with PEG-IFN ± lamivudine for 52 weeks. Patients were classified at baseline as wildtype (WT) or non-WT (detectable PC/BCP mutants). Combined response (HBeAg loss with HBV DNA < 2000 IU/mL), HBeAg response (HBeAg loss with HBV DNA > 2000 IU/mL) or non-response was assessed at week 78.
Mean baseline HBeAg levels were 2.65 logIU/mL in combined responders, 2.48 in non-responders and 2.24 in HBeAg responders (p = 0.034). Baseline HBeAg levels were not associated with combined response after stratification by WT/non-WT. Within the PEG-IFN monotherapy group (n = 104), patients with HBeAg < 1 logIU/mL at week 24 had a higher probability of combined response (29% versus 12%, p = 0.041). After stratification by WT/non-WT, WT patients with HBeAg < 1 logIU/mL at week 24 had a probability of combined response of 78% (versus 19% in patients with >1 logIU/mL, p < 0.001), whereas no difference in response rates was observed in non-WT patients (p = 0.848).
The relationship between HBeAg levels and response to PEG-IFN depends upon the presence of PC/BCP mutants. HBeAg levels should therefore not be routinely used to select patients for PEG-IFN, nor for monitoring of therapy.
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发表于 2013-2-20 09:58
