Early Serum HBsAg Drop: A Strong Predictor of Sustained Virological Response to Pegylated Interferon Alfa-2a in HBeAg-Negative Patients

被引:393
作者
Moucari, Rami [1 ,5 ,6 ]
Mackiewicz, Vincent [2 ]
Lada, Olivier [1 ,5 ,6 ]
Ripault, Marie-Pierre [1 ,5 ,6 ]
Castelnau, Corinne [1 ,5 ,6 ]
Martinot-Peignoux, Michelle [1 ,5 ,6 ]
Dauvergne, Agnes [3 ]
Asselah, Tarik [1 ,5 ,6 ]
Boyer, Nathalie [1 ,5 ,6 ]
Bedossa, Pierre [4 ]
Valla, Dominique [1 ,5 ,6 ]
Vidaud, Michel [3 ]
Nicolas-Chanoine, Marie-Helene [2 ]
Marcellin, Patrick [1 ,5 ,6 ]
机构
[1] Hop Beaujon, Serv Hepatol, F-92110 Clichy, France
[2] Hop Beaujon, Microbiol Serv, F-92110 Clichy, France
[3] Hop Beaujon, Serv Biochim, F-92110 Clichy, France
[4] Hop Beaujon, Serv Anat Pathol, F-92110 Clichy, France
[5] INSERM, U773, CRB3, Paris, France
[6] Univ Paris 07, Paris, France
关键词
CHRONIC HEPATITIS-B; PEGINTERFERON ALPHA-2A; ADEFOVIR DIPIVOXIL; THERAPY; LAMIVUDINE; SUPPRESSION;
D O I
10.1002/hep.22744
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Pegylated interferon alfa-2a (PEG-IFN) may induce sustained virological response (SVR) in 20% of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. In addition, loss of hepatitis B surface antigen (HBsAg) is achieved with a 10% yearly rate after treatment cessation in sustained responders. The aim of this study was to assess on-treatment serum HBsAg kinetics to predict SVR in HBeAg-negative patients treated with PEG-IFN. Forty-eight consecutive patients were treated with PEG-IFN (180 mu g/week) for 48 weeks. Serum hepatitis B virus (HBV) DNA (COBAS TaqMan) and HBsAg (Abbott Architect HBsAg QT assay) were assessed at baseline, during treatment (weeks 12, 24, and 48), and during follow-up (weeks 72 and 96). SVR was defined as undetectable serum HBV DNA (< 70 copies/mL) 24 weeks after treatment cessation. Twenty-five percent of patients achieved SVR. They were not different from those who failed treatment regarding age, sex, ethnicity, HBV genotype, baseline serum HBV DNA and HBsAg levels, or liver histology. During treatment, serum HBsAg levels decreased only in patients who developed SVR, with mean decreases of 0.8 +/- 0.5, 1.5 +/- 0.6, and 2.1 +/- 1.2 log(10) IU/mL at weeks 12,24, and 48, respectively. A decrease of 0.5 and 1 log(10) IU/mL in serum HBsAg levels at weeks 12 and 24 of therapy, respectively, had high predictive values of SVR (negative predictive value [NPV] 90%, positive predictive value [PPV] 89% for week 12; NPV 97%, PPV 92% for week 24). HBsAg loss was observed in three patients, all with SVR. Conclusion: Early serum HBsAg drop has high predictive values of SVR to PEG-IFN in HBeAg-negative CHB patients. Serum quantitative HBsAg may be a useful tool to optimize the management of PEG-IFN therapy in these patients. (HEPATOLOGY 2009;49:1151-1157.)
引用
收藏
页码:1151 / 1157
页数:7
相关论文
共 15 条
[1]   Predicting response to peginterferon α-2a, lamivudine and the two combined for HBeAg-negative chronic hepatitis B [J].
Bonino, F. ;
Marcellin, P. ;
Lau, G. K. K. ;
Hadziyannis, S. ;
Jin, R. ;
Piratvisuth, T. ;
Germanidis, G. ;
Yurdaydin, C. ;
Diago, M. ;
Gurel, S. ;
Lai, M-Y ;
Brunetto, M. R. ;
Farci, P. ;
Popescu, M. ;
McCloud, P. .
GUT, 2007, 56 (05) :699-705
[2]   HBeAg and hepatitis B virus DNA as outcome predictors during therapy with peginterferon alfa-2a for HBeAg-positive chronic hepatitis B [J].
Fried, Michael W. ;
Piratvisuth, Teerha ;
Lau, George K. K. ;
Marcellin, Patrick ;
Chow, Wan-Cheng ;
Cooksley, Graham ;
Luo, Kang-Xian ;
Paik, Seung Woon ;
Liaw, Yun-Fan ;
Button, Peter ;
Popescu, Matei .
HEPATOLOGY, 2008, 47 (02) :428-434
[3]   A pilot study of extended duration peginterferon alfa-2a for patients with hepatitis B e antigen-negative chronic hepatitis B [J].
Gish, Robert G. ;
Lau, Daryl T-Y ;
Schmid, Peter ;
Perrillo, Robert .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2007, 102 (12) :2718-2723
[4]   Long-term therapy with adefovir dipivoxil for HBeAg-negative chronic hepatitis B for up to 5 years [J].
Hadziyannis, Stephanos J. ;
Tassopoulos, Nicolaos C. ;
Heathcote, E. Jenny ;
Chang, Ting-Tsung ;
Kitis, George ;
Rizzetto, Mario ;
Marcellin, Patrick ;
Lik, Seng Gee ;
Goodman, Zachary ;
Ma, Jia ;
Brosgart, Carol L. ;
Eorroto-Esoda, Katyna ;
Arterburn, Sarah ;
Chuck, Steven L. .
GASTROENTEROLOGY, 2006, 131 (06) :1743-1751
[5]   Management of hepatitis B: Summary of a clinical research workshop [J].
Hoofnagle, Jay H. ;
Doo, Edward ;
Liang, T. Jake ;
Fleischer, Russell ;
Lok, Anna S. F. .
HEPATOLOGY, 2007, 45 (04) :1056-1075
[6]   MEASUREMENT OF HBSAG TO MONITOR HEPATITIS-B VIRAL REPLICATION IN PATIENTS ON ALPHA-INTERFERON THERAPY [J].
JANSSEN, HLA ;
KERHOFLOS, CJ ;
HEIJTINK, RA ;
SCHALM, SW .
ANTIVIRAL RESEARCH, 1994, 23 (3-4) :251-257
[7]   Long-term suppression of hepatitis B e antigen-negative chronic hepatitis B by 24-month interferon therapy [J].
Lampertico, P ;
Del Ninno, E ;
Viganò, M ;
Romeo, R ;
Donato, MF ;
Sablon, E ;
Morabito, A ;
Colombo, M .
HEPATOLOGY, 2003, 37 (04) :756-763
[8]   Chronic hepatitis B [J].
Lok, Anna S. F. ;
McMahon, Brian J. .
HEPATOLOGY, 2007, 45 (02) :507-539
[9]  
Manesis EK, 2007, ANTIVIR THER, V12, P73
[10]   Virological and biochemical response in patients with HBeAG-negative chronic hepatitis B treated with peginterferon alfa-2a (40KD) with or without lamivudine: Results of 4-year follow-up [J].
Marcellin, P. ;
Piratvisuth, T. ;
Brunetto, M. ;
Bonino, F. ;
Lau, G. K. K. ;
Farci, P. ;
Yurdaydin, C. ;
Wu, J. ;
Popescu, M. .
JOURNAL OF HEPATOLOGY, 2008, 48 :S46-S46