1. Sustained Response without Nucleos(t)ides after Pegylated Interferon Represent Favorable Outcome: Up to 13 Years Follow-up.
- Author
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Soon Kyu Lee, Jung Hyun Kwon, Jeong Won Jang, Heechul Nam, Yoon-jung Kim, Sun Hong Yoo, Soon Woo Nam, Si Hyun Bae, Jong Young Choi, and Seung Kew Yoon
- Subjects
CHRONIC hepatitis B ,HEPATITIS associated antigen ,INTERFERONS ,HEPATITIS B virus ,CIRRHOSIS of the liver ,VIRUS diseases - Abstract
Background/Aims Pegylated interferon (PEG-IFN) treatment with a high rate of off-therapy host immune control is still an attractive treatment for chronic hepatitis B virus (HBV) infection. There remains uncertain about the prognosis of sustained responder after PEG-IFN treatment who do not need nucleos(t)ides (NAs). We investigated the long-term outcomes of PEG-IFN treatment focused on tolerant patients without NAs up to 13 years. Methods A consecutive 172 patients treated with PEG-IFN for chronic hepatitis B or compensated liver cirrhosis between 2005 and 2014 were enrolled and finally 122 patients who fully completed PEG-IFN treatment were analyzed. The definition of response for PEG-IFN treatment at 6months posttreatment were as follows: hepatitis B e antigen (HBeAg) positive patients, achieve both virologic response (VR; <2,000 IU/mL of HBV DNA) and serologic response (HBeAg loss or seroconversion); HBeAg negative patients, reach VR. During follow-up period, we analyzed the number of patients with HBsAg loss, starting NAs due to viral activation and disease progression including liver cirrhosis and hepatocellular carcinoma (HCC). Results The median follow-up period of 122 patients were 7.2 years (range, 1.1 to 13.2 years). Of 122 patients, 43 patients (35.2%) had a response at 6 months posttreatment. During follow-up, 69 patients (56.6%) started NAs and the patients who had a response for PEG-IFN significantly lower rate of starting NAs (14/43 vs 55/79, p<0.001). HBsAg loss occurred in nine patients (7.4%) and sustained responders without further NAs treatment had significantly high rate of HBsAg loss compared to the patients with starting NAs (13.2% vs 2.9%, p=0.01). Eight patients (6.6%) developed disease progression including HCC (n=3). All of them were nonsustained responders who started NAs after PEG-IFN therapy compared to sustained responders (p=0.03). Conclusions Sustained responders without further NAs treatment after PEG-IFN treatment had a favorable clinical outcome in HBsAg loss and no disease progression up to 13 years. [ABSTRACT FROM AUTHOR]
- Published
- 2019