Retrospective Study
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World J Gastroenterol. Jul 7, 2014; 20(25): 8195-8200
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8195
Baseline HBsAg predicts response to pegylated interferon-α2b in HBeAg-positive chronic hepatitis B patients
Gong-Ying Chen, Meng-Fei Zhu, Da-Liang Zheng, Yan-Ting Bao, Jie Wang, Xiang Zhou, Guo-Qiang Lou
Gong-Ying Chen, Meng-Fei Zhu, Jie Wang, Guo-Qiang Lou, Hospital Affiliated to Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Da-Liang Zheng, Yan-Ting Bao, Xiang Zhou, the Sixth Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310012, Zhejiang Province, China
Author contributions: Chen GY and Zhu MF contributed equally to this work; Lou GQ and Chen GY designed the research; Zhu MF, Zheng DL and Bao YT performed the research; Wang J and Zhou X analyzed the data; Chen GY wrote the manuscript.
Supported by the Natural Science Foundation of Zhejiang Province, China, No. Y210435
Correspondence to: Dr. Guo-Qiang Lou, Hospital Affiliated to Hangzhou Normal University, 126 Wenzhou Road, Hangzhou 310015, Zhejiang Province, China. louguoqiang2008@126.com
Telephone: +86-571-88063403 Fax: +86-571-88021730
Received: October 30, 2013
Revised: January 16, 2014
Accepted: April 5, 2014
Published online: July 7, 2014
Abstract

AIM: To evaluate the predictive effect of baseline hepatitis B surface antigen (HBsAg) on response to pegylated interferon (PEG-IFN)-α2b in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients.

METHODS: This retrospective analysis compared the treatment efficacy of PEG-IFN-α2b alone in 55 HBeAg-positive CHB patients with different baseline HBsAg levels. Serum HBV DNA load was measured at baseline, and at 12, 24 and 48 wk of therapy. Virological response was defined as HBV DNA < 1000 IU/mL. Serum HBsAg titers were quantitatively assayed at baseline, and at 12 and 24 wk.

RESULTS: Eighteen patients had baseline HBsAg > 20 000 IU/mL, 26 patients had 1500-20000 IU/mL, and 11 patients had < 1500 IU/mL. Three (16.7%), 11 (42.3%) and seven (63.6%) patients in each group achieved a virological response at week 48, with a significant difference between groups with baseline HBsAg levels > 20000 or < 20000 IU/mL (P = 0.02). Thirteen patients had an HBsAg decline > 0.5 log10 and 30 patients < 0.5 log10 at week 12; and 6 (46.2%) and 10 (33.3%) in each group achieved virological response at week 48, with no significant difference between the two groups (P = 0.502). Eighteen patients had an HBsAg decline > 1.0 log10 and 30 patients < 1.0 log10 at week 24, and 8 (44.4%) and 11 (36.7%) achieved a virological response at week 48, with no significant difference between the two groups (P = 0.762). None of the 16 patients with HBsAg > 20000 IU/mL at week 24 achieved a virological response at week 48.

CONCLUSION: Baseline HBsAg level in combination with HBV DNA may become an effective predictor for guiding optimal therapy with PEG-IFN-α2b against HBeAg-positive CHB.

Keywords: Chronic hepatitis B, Hepatitis B surface antigen, Baseline, Virological response, Pegylated interferon-α2b

Core tip: The response to antiviral therapy in chronic hepatitis B (CHB) patients varies significantly among individuals. This retrospective study of 55 patients evaluated the predictive effect of baseline hepatitis B surface antigen (HBsAg) on virological response in HBeAg-positive CHB patients treated with pegylated interferon (PEG-IFN)-α2b. The results suggest that baseline HBsAg level in combination with HBV DNA quantitative values may become an effective predictor for guiding optimal therapy with PEG-IFN-α2b against HBeAg-positive CHB.