Consolidation treatment needed for sustained HBsAg-negative response induced by interferon-alpha in HBeAg positive chronic hepatitis B patients  

作　　者：Minghui Li Fangfang Sun Xiaoyue Bi Yanjie Lin Liu Yang Yao Lu Lu Zhang Gang Wan Wei Yi Linqing Zhao Yao Xie 

机构地区：[1]Department of Hepatology Division 2,Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China [2]Department of Hepatology Division 2,Peking University Ditan Teaching Hospital,Beijing,100015,China [3]Department of Biostatistics,Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China [4]Department of Gynecology and Obstetrics,Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China [5]Laboratory of Virology,Beijing Key Laboratory of Etiology of Viral Diseases in Children,Capital Institute of Pediatrics,Beijing,100020,China

出　　处：《Virologica Sinica》2022年第3期390-397,共8页中国病毒学（英文版）

基　　金：funded in part by the Beijing Municipal Science and Technology Commission(No.Z151100004015122);Beijing Municipal Administration of Hospitals’Clinical Medicine Development of special funding support(No.XMLX 201706 and XMLX202127);National Science and Technology Major Project of China(2017ZX10203202-003,2017ZX10201201-001-006,and 2017ZX10201201-002-006);Beijing Science and Technology Commission(No.D161100002716002);Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals(No.XXZ0302 and XXT28);Special public health project of Capital health development(2021-1G-4061 and 2022-1-2172)。

摘　　要：Hepatitis B surface antigen(HBsAg)clearance is considered as functional cure in patients with chronic hepatitis B(CHB).This study aimed to assess the durability of HBsAg clearance achieved by interferon-based therapies in patients with CHB who were originally positive for hepatitis B envelope antigen(HBeAg).In this prospective study,HBeAg-positive CHB patients with confirmed HBsAg loss under interferon-based therapies were enrolled within 12 weeks from end of treatment and followed up for 48 weeks.Virological markers,biochemical indicators,and liver imaging examinations were observed every 3–6 months.Sustained functional cure was analysed as primary outcome.Factor associated with sustained HBsAg loss or reversion was also investigated.The rate of HBsAg loss sustainability was 91.8%(212/231).Patients receiving consolidation treatment for 12–24weeks or≥24 weeks had higher rates of sustained HBsAg negativity than those receiving consolidation treatment for<12 weeks(98.3%and 91.2%vs.86.7%,P=0.068),and the former groups had significantly higher anti-HBs levels than the later(P<0.05).The cumulative incidence of HBsAg reversion and HBV DNA reversion was 8.2%and 3.9%,respectively.Consolidation treatment of≥12 weeks[odd ratio(OR)3.318,95%confidence interval(CI)1.077–10.224,P=0.037)was a predictor of sustained functional cure,and HBeAg-positivity at cessation of treatment(OR 12.271,95%CI 1.076–139.919,P=0.043)was a predictor of HBsAg reversion.Interferon-alpha induced functional cure was durable and a consolidation treatment of≥12–24 weeks was needed after HBsAg loss in HBeAg-positive CHB patients.

关 键 词：Chronic hepatitis B(CHB) Functional cure HBeAg positive HBsAg loss Interferon(IFN) 

分 类 号：R512.62[医药卫生—内科学] R446.6[医药卫生—临床医学]