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- 2022-12-28
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1874
A real-world experience in baseline predictors of virological
response to Peginterferon Alfa-2a in patients
with HBeAg-negative chronic hepatitis B
Yi-Cheng Chen1,2, Rachel Wen-Juei Jeng1,2, Chao-Wei Hsu1,2,
Chun-Yen Lin1,2, I-Shyan Sheen1,2, Rong-Nan Chien1,3, Yun -Fan
Liaw1,3; 1Liver Research Unit, Chang Gung Memorial Hospital,
Taoyuan, Taiwan; 2Gastroenterology and Hepatology, Chang
Gung Memorial Hospital, Taoyuan City, Taiwan; 3College of Medicine,
Chang Gung University, Taipei, Taiwan
Background and aims Peginterferon (Peg-IFN) alfa-2a is one
of the recommended first-line agents for treatment of chronic
hepatitis B (CHB). The baseline predictors of post-treatment
response to Peg-IFN alfa-2a is not well established. The aim
of this study is to explore baseline clinical characteristics to
find the predictors of virological response to Peg-IFN alfa-2a
in HBeAg-negative CHB at 48 weeks post-treatment in a realworld
clinical practice. Patients and methods A total of 127
patients with HBeAg-negative CHB were recruited retrospectively
from 2006 to 2013 in Chang Gung Memorial Hospital.
All patients were treated with Peg-IFN alfa-2a for 48-52 weeks.
Baseline clinical charateristics included alanine aminotransferase
(ALT), HBV DNA, quantitative HBsAg and HBV genotype.
Virological response was defined as HBV DNA <2000 IU/mL
at 48 weeks post-treatment. Stored serum were retrieved for
HBV DNA, HBsAg and genotype assays. Results The mean age
was 46.8±9.9 (median 45, range 26-69) years, males were
112 (88%) and genotype B were 97 (76.4%). The mean ALT
was 158.7±109.8 U/L. There were 39 (30.7%) patients with
ALT 5-fold upper limit of normal (5xULN). The mean HBsAg
and HBV DNA levels were 3.1±0.6 log IU/mL and 6.3±1.3
log IU/mL, respectively. VR and HBsAg seroclearance were
achieved in 38 (30%) and 6 (4.7%) patients, respectively.
Patients with VR were significantly younger than those without
(43.3 vs. 48.3 years, p=0.008). Age ≤45 years [odds ratio
(OR) 3.325, 95% confidence (CI) 1.357-8.148, p=0.009]
was a significantly independent predictor of VR in multivariate
logistic regression analysis. ALT ≥5xULN (OR 2.324, 95% CI
0.654-5.659, p=0.063) and HBsAg <650 IU/mL (OR 2.504,
95% CI 0.970-6.467, p=0.058) were marginally significant
predictors of VR. Among patients with age ≤45 years, 69.2%
of those with HBsAg <650 IU/mL, 56.3% of HBsAg <1000
IU/mL and 52.6% of ALT ≥5xULN could achieve VR. Combination
of HBsAg <650 IU/mL and ALT ≥5xULN or HBsAg <1000
IU/mL and ALT ≥5xULN would increase VR rate (from 17.6%
to 28.6% and 16.7% to 27.3%, respectively) in patients with
age >45 years. Conclusions Younger age (≤45 years) was
a significant baseline predictor of VR to Peg-IFN alfa-2a in
HBeAg-negative CHB. High rate of VR (~70%) could be
achieved in patients with age ≤45 years and baseline HBsAg
<650 IU/mL. Combination of baseline low HBsAg (<1000 IU/
mL) and high ALT (≥5xULN) levels would increase VR rate in
patients with age >45 years.
Disclosures:
Yun -Fan Liaw - Advisory Committees or Review Panels: Roche; Grant/Research
Support: Roche
The following people have nothing to disclose: Yi-Cheng Chen, Rachel Wen-Juei
Jeng, Chao-Wei Hsu, Chun-Yen Lin, I-Shyan Sheen, Rong-Nan Chien
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发表于 2016-11-28 18:00
