Hepatitis B virus genotype B results in better immediate, late and sustained responses to peginterferon-alfa in hepatitis-B-e-antigen-positive patients

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2010.06429.x/abstract

Hepatitis B virus genotype B results in better immediate, late and sustained

responses to peginterferon-alfa in hepatitis-B-e-antigen-positive patients

Chien-Hung Chen1,2, Chuan-Mo Lee1,2, Chao-Hung Hung1,2, Jing-Houng Wang1,2,

Tsung-Hui Hu1,2, Chi-Sin Changchien1,2, Sheng-Nan Lu1,2,*

Article first published online: 5 JUL 2010

DOI: 10.1111/j.1440-1746.2010.06429.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Volume 26, Issue 3, pages 461–468, March 2011

Abstract

Background and Aims:  This study investigated outcome predictors in

hepatitis-B-e-antigen (HBeAg)-positive chronic hepatitis B patients treated with

peginterferon alfa-2a.

Methods:  A total of 88 HBeAg-positive patients receiving peginterferon

alfa-2a for 6 months and followed up for at least 24 weeks were prospectively

analyzed. Precore and core promoter genes of hepatitis B virus (HBV) were

sequenced from the serial serum samples of 88 patients.

Results:  After 24 weeks of follow up, 38.6% and 28.4% of patients achieved

HBeAg clearance and combined response, respectively. Multivariate analysis

disclosed that pretreatment HBeAg sample to cut-off (S/Co) ratio ≤ 200,

alanine aminotransferase > 200 IU/mL, HBV genotype B and T1846 were independent

factors for HBeAg clearance, and HBeAg S/Co ratio ≤ 200 and HBV genotype B

were major determinants for combined response. HBeAg S/Co ratio ≤ 10 at week

12 of therapy was the useful factor for treatment response and had a greater

power (P = 0.012) to predict HBeAg clearance than HBV DNA. Patients with HBeAg

clearance had a higher frequency of A1896 mutation at baseline and during

therapy than those without HBeAg clearance, and the frequency of A1896 decreased

during treatment. During follow up, delayed HBeAg seroconversion and

reactivation of HBV after HBeAg clearance were observed in eight non-responders

and 20 patients with HBeAg clearance, respectively. HBV genotype B was a

significant factor to predict both responses.

Conclusions:  Pretreatment HBeAg S/Co ratio ≤ 200 and HBV genotype B were

major determinants for treatment response to peginterferon. Genotype-B-infected

patients had higher probability of delayed HBeAg clearance and sustained

response. Rapid decrease of HBeAg titer was useful on treatment predictor.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2010.06429.x/abstract

Hepatitis B virus genotype B results in better immediate, late and sustained

responses to peginterferon-alfa in hepatitis-B-e-antigen-positive patients

Chien-Hung Chen1,2, Chuan-Mo Lee1,2, Chao-Hung Hung1,2, Jing-Houng Wang1,2,

Tsung-Hui Hu1,2, Chi-Sin Changchien1,2, Sheng-Nan Lu1,2,*

Article first published online: 5 JUL 2010

DOI: 10.1111/j.1440-1746.2010.06429.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Volume 26, Issue 3, pages 461–468, March 2011

Abstract

Background and Aims:  This study investigated outcome predictors in

hepatitis-B-e-antigen (HBeAg)-positive chronic hepatitis B patients treated with

peginterferon alfa-2a.

Methods:  A total of 88 HBeAg-positive patients receiving peginterferon

alfa-2a for 6 months and followed up for at least 24 weeks were prospectively

analyzed. Precore and core promoter genes of hepatitis B virus (HBV) were

sequenced from the serial serum samples of 88 patients.

Results:  After 24 weeks of follow up, 38.6% and 28.4% of patients achieved

HBeAg clearance and combined response, respectively. Multivariate analysis

disclosed that pretreatment HBeAg sample to cut-off (S/Co) ratio ≤ 200,

alanine aminotransferase > 200 IU/mL, HBV genotype B and T1846 were independent

factors for HBeAg clearance, and HBeAg S/Co ratio ≤ 200 and HBV genotype B

were major determinants for combined response. HBeAg S/Co ratio ≤ 10 at week

12 of therapy was the useful factor for treatment response and had a greater

power (P = 0.012) to predict HBeAg clearance than HBV DNA. Patients with HBeAg

clearance had a higher frequency of A1896 mutation at baseline and during

therapy than those without HBeAg clearance, and the frequency of A1896 decreased

during treatment. During follow up, delayed HBeAg seroconversion and

reactivation of HBV after HBeAg clearance were observed in eight non-responders

and 20 patients with HBeAg clearance, respectively. HBV genotype B was a

significant factor to predict both responses.

Conclusions:  Pretreatment HBeAg S/Co ratio ≤ 200 and HBV genotype B were

major determinants for treatment response to peginterferon. Genotype-B-infected

patients had higher probability of delayed HBeAg clearance and sustained

response. Rapid decrease of HBeAg titer was useful on treatment predictor.