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Effect of switching from nucleos(t)ide maintenance therapy to PegIFN alfa-2a in patients with HBeAg-positive chronic hepatitis B: A randomized trial

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Author(s)
Hyun Young WooJeong HeoWon Young TakHeon Ju LeeWoo Jin ChungJung Gil ParkSoo Young ParkYoung Joo ParkYu Rim LeeJae Seok HwangYoung Oh Kweon
Keimyung Author(s)
Chung, Woo JinHwang, Jae Seok
Department
Dept. of Internal Medicine (내과학)
Journal Title
PLoS One
Issued Date
2022
Volume
17
Issue
7
Abstract
Aims:
Induction of a durable viral response is difficult to achieve in patients with chronic hepatitis B (CHB), even from long-term use of a nucleos(t)ide analogue (NA). This study investigated whether switching to peginterferon (PegIFN) alfa-2a after long-term NA therapy induced a durable viral response.

Methods:
Patients with hepatitis B e antigen (HBeAg)-positive CHB who received any NA for at least 72 weeks and had a low level of HBV DNA (≤100 IU/mL) were randomized (1:1) to receive PegIFN alfa-2a (180 μg/week) or NA for 48 weeks. The primary endpoint was change in the hepatitis B surface antigen (HBsAg) titer during antiviral therapy.

Results:
We randomized 149 CHB patients to the two groups. Compared to baseline, the HBsAg levels in both groups were not lower at week 12, but were lower after 24, 36, and 48 weeks (all p<0.001). The maximal HBsAg decline in the PegIFN alfa-2a group was at week 36 (0.50±0.88 log10 IU/mL), and this decline was smaller in the NA group (0.08±0.46 log10 IU/mL). The percentage of patients with HBeAg seroconversion at week 48 was also greater in the PegIFN alfa-2a group (15/75 [20.0%] vs. 5/74 [6.8%], p = 0.018). Multivariable analysis indicated the PegIFN alfa-2a group had a greater change in HBeAg seroconversion at week 48 (p = 0.027). Patients had relatively good tolerance to PegIFN alfa-2a therapy.

Conclusions:
CHB patients who switched to PegIFN alfa-2a for 48 weeks had a significantly lower HBsAg titer and increased HBeAg seroconversion relative to those who remained on NA therapy.
Keimyung Author(s)(Kor)
정우진
황재석
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1932-6203
Source
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0270716
DOI
10.1371/journal.pone.0270716
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44400
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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