Hepatitis B Virus Surface Antigen Levels: A Guide to Sustained Response to peginterferon alfa-2a in HBeAg-Negative Chronic Hepatitis B

被引：398

作者：

Brunetto, Maurizia Rossana ^{[1
]}

Moriconi, Francesco ^{[1
]}

Bonino, Ferruccio ^{[2
,3
]}

Lau, George K. K. ^{[4
]}

Farci, Patrizia ^{[5
]}

Yurdaydin, Cihan ^{[6
]}

Piratvisuth, Teerha ^{[7
]}

Luo, Kanxian ^{[8
]}

Wang, Yuming ^{[9
]}

Hadziyannis, Stephanos ^{[10
]}

Wolf, Eva ^{[11
]}

McCloud, Philip

Batrla, Richard ^{[12
]}

Marcellin, Patrick ^{[13
]}

机构：

[1] Azienda Osped Univ Pisana, UO Epatol, Pisa, Italy

[2] Fdn IRCCS Policlin Milan, Milan, Italy

[3] Univ Pisa, I-56100 Pisa, Italy

[4] Queen Mary Hosp, Dept Med, Hong Kong, Hong Kong, Peoples R China

[5] Univ Cagliari, Dipartimento Sci Med, Monserrato, Italy

[6] Ankara Univ, Dept Gastroenterol, TR-06100 Ankara, Turkey

[7] Prince Songkla Univ, Songklanagarind Hosp, Dept Internal Med, Hat Yai, Thailand

[8] Nanfang Hosp, Dept Infect Dis, Guangzhou, Guangdong, Peoples R China

[9] Xinan Hosp, Dept Infect Dis, Chongqing, Peoples R China

[10] Henry Dunant Hosp, Dept Med & Hepatol, Athens, Greece

[11] MUC Res, Munich, Germany

[12] Roche, Basel, Switzerland

[13] Univ Paris, Hop Beaujon, Clichy, France

来源：

HEPATOLOGY | 2009年 / 49卷 / 04期

关键词：

LONG-TERM THERAPY; ADEFOVIR DIPIVOXIL; INTERFERON-ALPHA; SERUM HBSAG; LAMIVUDINE; COMBINATION; INFECTION; CIRRHOSIS;

D O I：

10.1002/hep.22760

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

We investigated the relationship between hepatitis B virus surface antigen (HBsAg) serum level decline and posttreatment response in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B from a large multinational study of pegylated interferon alfa-2a (peginterferon alfa-2a), with or without lamivudine, versus lamivudine alone. Serum HBsAg was quantified using the Architect assay (Abbott Diagnostics) at pretreatment, end of treatment (week 48), and 6 months after the end of treatment (week 72) in sera from 386 of the 537 patients who participated in the multinational study (peginterferon alfa-2a, 127; peginterferon alfa-2a plus lamiviadine, 137; lamivudine monotherapy, 122). Pretreatment HBsAg levels varied according to genotype, with the highest levels present in patients infected with genotypes A (median, 4.11 log(10) IU/mL) and D (median, 3.85 log(10) IU/mL). Significant on-treatment decline in HBsAg was observed during treatment: with peginterferon alfa-2a (alone or combined with lamivudine; mean decline at week 48, -0.71 and -0.67 log(10) IU/mL, respectively, P < 0.001), but not during treatment with lamivudine alone (-0.02 log(10) IU/mL. Significantly more patients treated with peginterferon alfa-2a (21%) or peginterferon a1fa-2a plus lamivudine (17%) achieved HBsAg levels <100 IU/mL at the end of treatment compared with lamivudine (1%) (both P < 0.001 versus lamivudine). End-of-treatment HBsAg level correlated strongly with HBV DNA suppression to <= 400 copies/mL 6 months posttreatment. An HBsAg level < 10 IU/mL at week 48 and on-treatment decline > 1 log10 IU/mL were significantly associated with sustained HBsAg clearance 3 years after treatment (both P < 0.0001). Conclusion: On-treatment quantification of HBsAg in patients with HBeAg-negative chronic hepatitis B treated with peginterferon alfa-2a may help identify those likely to be cured by this therapy and optimize treatment strategies. (HEPATOLOGY 2009;49:1141-1150.)

引用

页码：1141 / 1150

页数：10

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