scholarly journals HBsAg quantification predicts off-treatment response to interferon in chronic hepatitis B patients:A retrospective study of 250 cases

2019 ◽  
Author(s):  
Shuai Wu ◽  
Wenfan Luo ◽  
Yin Wu ◽  
Hongjie Chen ◽  
Jie Peng

Abstract Background: For chronic hepatitis B (CHB) patients without willingness to extend the routine duration of interferon (IFN) therapy, it is important to identify patients who will benefit from treatment cessation. Hepatitis B surface antigen (HBsAg) quantification is recommended for management of IFN therapy. At present, the understanding on end-of-treatment (EOT) HBsAg level predicting post-treatment response to IFN is still finite. Methods: Patients with CHB infection and treated with IFN-based therapy during the period from December 2010 to December 2017 at Nanfang Hospital were enrolled in this study. Serum HBsAg levels at EOT were measured to evaluate the associations between EOT HBsAg levels (Group 1, HBsAg >0.05 and ≤10 IU/mL; Group 2, HBsAg >10 and ≤200 IU/mL; Group 3, HBsAg >200 IU/mL) with post-treatment HBsAg loss. Chi-squared, t-test, ,Kaplan-Meier analysis, Cox regression analysis, and Multivariate Logistic regression analysis were used to analyse and evaluate differences between the there groups. Results: The cumulative HBsAg loss rates 5 years after treatment in Group 1-3 were 30.4% (17/56), 9.8%(4/41) and 0%(0/153) (p<0.001). An EOT HBsAg level of >10 IU/mL showed relatively high negative predictive value (NPV) of up to 97.9% for HBsAg loss. Low baseline HBsAg level <25000 IU/mL, on-treatment HBsAg decline >1 log10IU/mL at week 24 and EOT HBsAg level ≤10 IU/mL were found significantly associated with HBsAg loss. A total of 6 patients have achieved HBsAg loss at EOT and 17 patients with EOT HBsAg level ≤10 IU/mL have achieved post-treatment HBsAg loss. Baseline characteristics, dynamic changes of on-treatment HBsAg and duration of IFN therapy were balanced across patients with EOT or post-treatment HBsAg loss. Conclusion: EOT HBsAg level can serve as a monitoring indicator for IFN therapy. EOT HBsAg level ≤10 IU/mL was found to lead to high rate of post-treatment HBsAg loss. For patients without willingness to extend IFN treatment, off-treatment follow-up could be considered when HBsAg level decreased to ≤10 IU/mL.

2020 ◽  
Author(s):  
Shuai Wu ◽  
Wenfan Luo ◽  
Yin Wu ◽  
Hongjie Chen ◽  
Jie Peng

Abstract Background: For chronic hepatitis B (CHB) patients without willingness to extend the routine duration of interferon (IFN) therapy, it is important to identify patients who will benefit from treatment cessation. Hepatitis B surface antigen (HBsAg) quantification is recommended for management of IFN therapy. At present, the understanding on end-of-treatment (EOT) HBsAg level predicting post-treatment response to IFN is still finite. Methods: Patients with CHB infection and treated with IFN-based therapy during the period from December 2010 to December 2017 at Nanfang Hospital were enrolled in this study. Serum HBsAg levels at EOT were measured to evaluate the associations between EOT HBsAg levels (Group 1, HBsAg >0.05 and ≤10 IU/mL; Group 2, HBsAg >10 and ≤200 IU/mL; Group 3, HBsAg >200 IU/mL) with post-treatment HBsAg loss. Chi-squared, t-test, ,Kaplan-Meier analysis, Cox regression analysis, and Multivariate Logistic regression analysis were used to analyse and evaluate differences between the there groups. Results: The cumulative HBsAg loss rates 5 years after treatment in Group 1-3 were 30.4% (17/56), 9.8%(4/41) and 0%(0/153) (p<0.001). An EOT HBsAg level of >10 IU/mL showed relatively high negative predictive value (NPV) of up to 97.9% for HBsAg loss. Low baseline HBsAg level <25000 IU/mL, on-treatment HBsAg decline >1 log10IU/mL at week 24 and EOT HBsAg level ≤10 IU/mL were found significantly associated with HBsAg loss. A total of 6 patients have achieved HBsAg loss at EOT and 17 patients with EOT HBsAg level ≤10 IU/mL have achieved post-treatment HBsAg loss. Baseline characteristics, dynamic changes of on-treatment HBsAg and duration of IFN therapy were balanced across patients with EOT or post-treatment HBsAg loss. Conclusion: EOT HBsAg level can serve as a monitoring indicator for IFN therapy. EOT HBsAg level ≤10 IU/mL was found to lead to high rate of post-treatment HBsAg loss. For patients without willingness to extend IFN treatment, off-treatment follow-up could be considered when HBsAg level decreased to ≤10 IU/mL.


2021 ◽  
pp. 135965352110598
Author(s):  
Yu-Qing Fang ◽  
Xiao-Yan Xu ◽  
Feng-Qin Hou ◽  
Wei Jia

Background Few models to predict antiviral response of peginterferon were used in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients and the prediction efficacy was unsatisfied. Quantitative antibody to hepatitis B core antigen (anti-HBc) is a new predictor of treatment response. We aimed to develop a new model to identify HBeAg-positive Chinese patients who were more likely to respond to peginterferon. Methods Data from 140 peginterferon recipients with HBeAg-positive were applied with generalized additive models and multiple logistic regression analysis to develop a baseline scoring system to predict serological response (SR: HBeAg loss and HBeAg seroconversion 24 weeks post-treatment) and combined response (CR: SR plus serum HBV DNA levels <2000 IU/mL 24 weeks post-treatment). Results Anti-HBc levels, alanine aminotransferase ratio, and HBeAg were retained in the final model. The new model scored from 0 to 3. Among patients with scores of 0, 1, or ≥2, SR was achieved in 6.45% (2/31), 13.21% (7/51), and 55.36% (31/56), respectively, and CR in 3.23% (1/31), 9.43% (5/53), and 25.00% (14/56), respectively. Our model has a higher AUROC for SR comparing to Chan’s (Z = 2.77 > 1.96, p < 0.05) and Lampertico’s (Z = 2.06 > 1.96, p < 0.05) model. The negative predictive value for SR and CR were both 100% in patients with score 0 and hepatitis B surface antigen ≥20,000 IU/mL at week 12. Conclusions Patients with higher scores at baseline were more likely to respond to peginterferon. This new model may predict the treatment response.


2021 ◽  
Author(s):  
Peipei Ren ◽  
Hu Li ◽  
Yan Huang ◽  
Jiayuan Jiang ◽  
Simin Guo ◽  
...  

Abstract Background: Rational administration of peginterferon can remarkably reduce serum HBsAg level and improve the rate of HBsAg loss. Considering the high cost and low tolerability of peginterferon, we aimed to develop a simple-to-use scoring system at early stage of treatment to predict low HBsAg level or HBsAg loss at the end of treatment in virological suppressed chronic hepatitis B (CHB) patients.Methods: Non-cirrhotic CHB patients with NA (nucleoside/nucleotide analogues)-induced virological suppression initiated peginterferon treatment by either add-on or switch-to strategy for 48 weeks were enrolled from January 2012 to June 2017 in two tertiary centers. The retrospective design enrolled 320 subjects, including 189 patients in the training cohort and 131 patients in the validation cohort.Results: By logistic regression, a simple-to-use scoring system integrating baseline HBsAg level < 1000 IU/mL, HBsAg decline > 0.5 log at week 12 and ALT flare at week 12 was developed in the training cohort and high performance for predicting HBsAg < 100 IU/mL, HBsAg < 10 IU/mL and HBsAg loss at the end of 48-week treatment. The area under receiver operating characteristics curve was 0.84, 0.80 and 0.76 in the training cohort and 0.88, 0.87 and 0.84 in the validation cohort, respectively.Conclusions: Our simple-to-use scoring system can guide clinicians to decide whether to continue peginterferon treatment in CHB patients in order to achieve low HBsAg levels or HBsAg loss at the end of treatment, which might greatly improve the opportunity to reach a functional cure in these patients and lead more cost-effective treatment decision.


2009 ◽  
Vol 46 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Pisit Tangkijvanich ◽  
Piyawat Komolmit ◽  
Varocha Mahachai ◽  
Pattaratida Sa-nguanmoo ◽  
Apiradee Theamboonlers ◽  
...  

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