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P0656
ADD ON PEGINTERFERON TO ADEFOVIR ENHANCES HBsAg LOSS
IN INACTIVE HBV CARRIERS
M. Martinot Peignoux1, F. Mouri2, N. Boyer3, C. Castelnau4,
M. Pouteau5, N. Giuly4, T. Asselah4, P. Marcellin4. 1CRI Paris
Montmartre UMR1149 inserm, Hˆopital Beaujon AP-HP, 2Service
d’h´epatologie, CRI paris Montmartre UMR1149 inserm, 3Service
d’h´epatologie, Hˆopital Beaujon, 4Service d’h´epatologie, 5Service
H´epatologie, Hˆopital Beaujon AP-HP, Clichy, France
E-mail: [email protected]
Background and Aims: HBsAg loss, considered to be the ideal
outcome of HBV infection, occurs spontaneously at low rate in
inactive HBV carriers not candidates for therapy. We investigated
the ability of treatment to achieve accelerate incidence of HBsAg
loss in inactive carriers
Methods: 91 inactive carriers from a well phenotyped cohort
(Journal of Clinical Virology 2013; 58: 401) were followed
for a 2 years period. At that time point 69 remained
untreated, 22 underwent 4 years adefovir therapy. At 4 years
16 patients received 48 weeks peginterferon, 6 continued adefovir
monotherapy. All the patients ended therapy at 5 years, and were
followed for at least 2 years after treatment cessation.
Results: At baseline; ALT were 24±7 and 23±7 (ns), HBV genotypes
A, B–C, D, E observed in 33%, 15%, 33%, 19% in untreated
and 37%, 20%, 37%, 6% in treated patients (ns). HBsAg levels
3.24±1.0 and 3.34±0.92 log IU/ml (ns), HBVDNA levels 2.57±0.97
and 2.90±0.84 log IU/ml (ns), in untreated and treated patients,
respectively. At the end of follow up, HBVDNA was undetectable
in 12/69 (17%) of untreated and 9/22 (41%) of treated patients
(p < 0.02), an HBsAg loss was observed in 10/69 (15%) of untreated
and 7/22 (32%) of treated patients, (p = 0.06). A baseline HBsAg level
>3.3 log IU/ml shows a negative predictive value (NPV) of 92% for
HBs loss. Among the treated patients a HBs loss was observed
in 0/6 (0%) receiving adefovir and 7/16 (44%) receiving add-on
peginterferon (p = 0.04). Baseline HBsAg levels were 3.50±0.99
and 2.88±1.16 log IU/ml in adefovir and add-on peginterferon
therapy patients, respectively (ns). In the 16 patients receiving addon
peginterferon therapy, baseline HBsAg levels were 1.97±0.83
and 3.59±0.74 log IU/ml in patients with or without HBsAg loss,
respectively (p < 0.001). An HBsAg titer >3.3 log IU/ml shows a
NPV 100% for HBsAg loss. No patient relapsed.
Conclusions: In inactive HBV carriers treated with adefovir add-on
peginterferon dramatically accelerates the HBsAg decline and rate
of HBsAg loss (44%), in comparison to untreated patients (17%).
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发表于 2015-5-27 19:38
