Hepatitis B surface antigen: association with sustained response to peginterferon alfa-2a in hepatitis B e antigen-positive patients

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Hepatitis B surface antigen: association with sustained response to

peginterferon alfa-2a in hepatitis B e antigen-positive patients

Hepatology International, 06/27/2011

Piratvisuth T et al. - Hepatitis B surface antigen(HBsAg) levels at baseline

strongly associated with posttreatment response were not identified. Low HBsAg

levels during peginterferon alfa-2a therapy were associated with high rates of

posttreatment response. On-treatment HBsAg quantification may, therefore, help

guide patient management in the future.

Methods

.. Patients (n= 399) treated with peginterferon alfa-2a (180 ìg/week) alone or in

combination with lamivudine (100 mg/day) for 48 weeks during a large, randomized

study were included in this retrospective analysis.

.. Receiver-operating characteristic analyses were used to identify baseline and

on-treatment HBsAg levels associated with response (HBeAg seroconversion 6

months posttreatment).

Results

.. Baseline HBsAg levels were lower in patients achieving posttreatment response

than in nonresponders (3.97 and 4.21 IU/mL, respectively, p= 0.039).

.. Two baseline HBsAg cutoff levels (5,000 and 50,000 IU/mL) provided a positive

predictive value of 42% and a negative predictive value of 77%.

.. HBsAg decline was significantly greater during and posttreatment in responders

than in nonresponders (p< 0.0001).

.. HBeAg seroconversion rates 6 months posttreatment were significantly higher in

patients with HBsAg < 1,500 IU/mL at weeks 12 and 24 (56.7 and 54.4%,

respectively) versus patients with HBsAg 1,500-20,000 IU/mL (32.3 and 26.1%,

respectively) or HBsAg < 20,000 IU/mL (16.3 and 15.4%, respectively) (all p <

0.0001 and < 0.0001).