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http://www.hivandhepatitis.com/hep_b.html

Treatment with PegInterferon Alfa-2b: HBsAg Loss Is Associated with HBV Genotype

Loss of hepatitis B surface antigen (HBsAg) is the strongest indicator of a complete response to therapy for chronic hepatitis B, including normal ALT values and decreased risk for liver disease and liver cancer (hepatocellular carcinoma). In the current study, conducted by researchers in the Department of Gastroenterology and Hepatology at UC Rotterdam, The Netherlands, 7% of patients treated with peginterferon alfa-2b (PegIntron) monotherapy achieved loss of HBsAg while 6% experienced HBsAg seroconversion.

Results of the study appear in the current issue of The Journal of Gastroenterology (February 2006).

This was a multicenter randomized controlled trial in which 266 HBeAg-positive patients were treated for 52 wks with PegIntron 100 microgram/wk in combination with either lamivudine [Epivir-HBV] 100 mg/day or placebo.

Results

·         At the end of the 26-week follow up, 95 (36%) of the 266 patients experienced HBeAg loss, 18 (7%) HBsAg loss, and 16 (6%) HBsAg seroconversion.

·         Addition of lamivudine did not enhance HBeAg loss, HBsAg loss, or development of anti-HBs.

·         All 18 patients who showed HBsAg loss had normal ALT; 11 (61%) of these patients were also hepatitis B virus (HBV) DNA negative (<400 copies/mL) at the end of follow-up.

·         Interestingly, the loss of HBsAg differed according to HBV genotype: 14% for genotype A, 9% for genotype B, 3% for genotype C, and 2% for genotype D.

Based on these results, the authors conclude, “One year of Peg-interferon alfa-2b for HBeAg-positive patients led to HBsAg loss in 7%. Our study indicates that treatment with Peg-interferon α-2b is the best therapy to achieve HBsAg clearance in patients with genotype A.”

02/24/06

Reference
H J Flink and others (for the HBV 99-01 Study Group). Treatment with Peg-Interferon a-2b for HBeAg-Positive Chronic Hepatitis B: HBsAg Loss Is Associated with HBV Genotype. The American Journal of Gastroenterology 101(2): 297-303. February 2006.