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466
THE EFFECTS AND PREDICTORS OF PEG-INTERFERON BASED
ANTIVIRAL THERAPY OPTIMIZATION ON FUNCTIONAL CURE
IN NAS-TREATED CHB PATIENTS
Peipei Ren Jr.1, Hu Li2, Zhujun Cao1, Lichang Chen1, Tianhui
Zhou1, Minghao Cai1, Simin Guo1, Qing Guo1, Wei Cai1, Hui
Wang1, Peng Hu2 and Qing Xie3, (1) Department of Infectious
Diseases, Ruijin Hospital, Shanghai Jiao Tong University
School of Medicine, (2) Department of Infectious Diseases,
The Second Affiliated Hospital of Chongqing Medical
University, (3)Department of Infectious Diseases, Ruijin
Hospital, Shanghai Jiaotong University School of Medicine
Background: The effects of peg-interferon (PEG-IFN) based
Antiviral therapy optimization on the functional cure in chronic
Hepatitis B (CHB) remains to be further investigated. We
Evaluated the effects of different strategies with PEG-IFN
On functional cure for NAs-treated CHB patient achieving
Viral response Methods: We included patients from the
Department of Infectious Diseases of Ruijin Hospital Affiliated
To Shanghai Jiao Tong University School of Medicine and the
Second Affiliated Hospital of Chongqing Medical University
From January 2012 to June 2017 The inclusion criterion was
HBeAg negative and noncirrhotic NAs-treated CHB patients
Achieving virological response who continued to achieve
Add-on or switch-to therapy with PEG-IFN ≥ 24 weeks. K-M
Curves, Cox regression, propensity score matching (PSM)
And ROC curves were used Results:
1 Totally, 250 patients were included with 50 cases
Acquired HBsAg clearance during the median
48-week follow-up The overall cumulative
Incidence of HBsAg clearance in the add-on (n =
120) and switch-to (n = 130) group was 31 29%
Vs 28 01%, p = 0 20 After PSM, similar results
Were obtained
2 Multivariate Cox analysis showed that baseline
HBsAg levels, and HBsAg reduction at 24 weeks
Were independent factors for HBsAg clearance
The above-mentioned two indicators were
Relative good predictors for HBsAg clearance
The AUROC was 0 869, 0 932; the cut-off values
Were 500 IU/mL, 0 75 log10 IU/mL, respectively
3 The entire cohort was divided into four groups
Based on the cutoff values of 500 IU/mL for
HBsAg level at baseline and 0 75 log10 IU/mL
For HBsAg reduction at 24 weeks The overall
Cumulative incidence of HBsAg clearance for
Patients with HBsAg at baseline < 500 IU/mL and
HBsAg reduction at 24 weeks > 0.75 log10 IU/mL
Was 85.87%, significantly higher than the other
Three groups (all p values < 0 05) (Fig 1)
Conclusion: 1 For HBeAg negative and noncirrhotic
CHB patients with viral response by NAs, there was
No significant difference in the cumulative incidence of
HBsAg clearance between the add-on and switch-to
Therapy with PEG-IFN 2 Baseline HBsAg level and
HBsAg reduction at 24 weeks during treatment were
Independent factors of HBsAg clearance Patients
With baseline HBsAg level < 500 IU/mL and HBsAg
Reduction at 24 weeks > 0.75 log10 IU/mL were the benefit
Population. |
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发表于 2019-10-27 14:59