scholarly journals Peginterferon and Entecavir combination therapy improves outcome of non-early response Hepatitis B e antigen-positive patients

2020 ◽  
Author(s):  
Lu Chen ◽  
Lanyi Lin ◽  
Huijuan Zhou ◽  
Weiliang Tang ◽  
Hui Wang ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Combination Therapy ◽  
Treatment Outcomes ◽  
Combined Therapy ◽  
Pegylated Interferon ◽  
Early Response ◽  
Hbv Dna ◽  
Hepatitis B E Antigen ◽  
Treatment Naïve ◽  
Positive Hbeag

Abstract Background It is still controversial that the efficacy of nucleot(s)ide analogs (NAs) and pegylated interferon (PegIFN) combination therapy for hepatitis B e antigen positive (HBeAg +) patients. It was assessed whether PegIFN and entecavir (ETV) combination therapy could bring more benefit for HBeAg + patients. Methods The treatment naïve HBeAg + patients initiated with PegIFN alfa-2a (PegIFNα-2a) for 24 weeks without early response (early response: HBsAg < 1500 IU/mL and HBV DNA < 10 5 copies/mL) were recruited in the current study. Among total of 94 patients, 51 were continued with PegIFNα-2a monotherapy, 43 were offered PegIFNα-2a and ETV combined therapy. Results It was demonstrated that better outcomes in response to the combined therapy compared to that of the monotherapy, including more HBsAg decline and loss, HBV DNA decline and HBeAg clearance. Importantly, the patients with HBsAg levels between 1500 - 20,000 IU/mL initially or between 5000 - 20000 IU/mL after 24 weeks of PegIFNα-2a were more benefit from the combined therapy, compared to that of monotherapy. Conclusions The combined therapy of PegIFNα-2a and ETV is more efficacy for HBeAg + patients without early response to PegIFN monotherapy, and the HBsAg levels are a good predictor of the treatment outcomes.

scholarly journals Sequential Combination Therapy with Pegylated Interferon Leads to Loss of Hepatitis B Surface Antigen and Hepatitis B e Antigen (HBeAg) Seroconversion in HBeAg-Positive Chronic Hepatitis B Patients Receiving Long-Term Entecavir Treatment

2015 ◽  
Vol 59 (7) ◽  
pp. 4121-4128 ◽  
Author(s):  
Guo-Jun Li ◽  
Yi-Qi Yu ◽  
Shao-Long Chen ◽  
Ping Fan ◽  
Ling-Yun Shao ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Combination Therapy ◽  
Therapy Group ◽  
Hepatitis B Surface Antigen ◽  
Hbeag Seroconversion ◽  
Pegylated Interferon ◽  
Hepatitis B E Antigen ◽  
Sequential Combination

ABSTRACTNucleos(t)ide analogues rarely result in a durable off-treatment response in chronic hepatitis B infection, whereas pegylated interferon (Peg-IFN) induces a long-lasting response only in a subset of patients. We assessed the effect of sequential combination therapy with Peg-IFN-α2a and entecavir in hepatitis B e antigen (HBeAg)-positive patients with prior long-term entecavir therapy and investigated the predictors of response to treatment. HBeAg-positive individuals who did not achieve HBeAg seroconversion during previous long-term entecavir therapy, receiving Peg-IFN-α2a added to ongoing entecavir therapy (sequential combination [S-C] therapy;n= 81) for 48 weeks or remaining on entecavir monotherapy (n= 116), were retrospectively included. A matched pair was created at a 1:1 ratio from each treatment group. The primary endpoint was HBeAg seroconversion at week 48. Subgroup analysis of response prediction was conducted for 81 patients with S-C therapy. More patients in the S-C therapy group achieved HBeAg seroconversion than those in the entecavir group (44% versus 6%;P< 0.0001). An HBeAg level of <200 signal-to-cutoff ratio (S/CO) at baseline was a strong predictor for higher HBeAg seroconversion than that achieved when HBeAg was ≥200 S/CO (64.2% versus 17.9%;P< 0.0001). Hepatitis B surface antigen (HBsAg) levels at baseline and the decrease in HBsAg levels predicted HBsAg loss in the S-C therapy group. The combination of baseline HBeAg of <200 S/CO and HBsAg of <1,000 IU/ml and an HBsAg decline at week 12 of ≥0.5 log10IU/ml provided the highest rate of HBeAg seroconversion (92.31%) and HBsAg loss (83.3%) at week 48. Patients receiving sequential combination therapy have a higher rate of HBeAg seroconversion and are more likely to experience HBsAg clearance than do those continuing entecavir monotherapy. Sequential combination therapy can be guided by baseline HBsAg/HBeAg levels and on-treatment HBsAg dynamics.

scholarly journals Serum miR-192-5p Levels Predict the Efficacy of Pegylated Interferon Therapy for Chronic Hepatitis B

2021 ◽  
Author(s):  
Yoshihito Nagura ◽  
Kentaro Matsuura ◽  
Etsuko Iio ◽  
Koji Fujita ◽  
Takako Inoue ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Multivariate Logistic Regression Analysis ◽  
Pegylated Interferon ◽  
Hbv Dna ◽  
Multivariate Logistic Regression ◽  
Hepatitis B E Antigen ◽  
End Of Treatment

Abstract We examined the association between serum miRNA (-192-5p, -122-3p, -320a and − 6126-5p) levels and the efficacy of pegylated interferon (Peg-IFN) monotherapy for chronic hepatitis B (CHB) patients. We enrolled 61 CHB patients treated with Peg-IFNα-2a weekly for 48 weeks, of whom 12 had a virological response (VR) and 49 did not VR (non-VR). A VR was defined as HBV DNA < 2,000 IU/ml, hepatitis B e antigen (HBeAg)-negative, and nucleos(t)ide analogue free at 48 weeks after the end of treatment. The non-VR group showed a significantly higher HBeAg-positivity rate, ALT, HBV DNA, and serum miR-192-5p levels at baseline (P = 0.024, P = 0.020, P = 0.007, P = 0.021, respectively). Serum miR-192-5p levels at 24 weeks after the start of treatment were also significantly higher in the non-VR than the VR group (P = 0.011). Multivariate logistic regression analysis for predicting VR showed that miR-192-5p level at baseline was an independent factor. Serum miR-192-5p levels were significantly correlated with the levels of HBV DNA, hepatitis B core-related antigen, and hepatitis B surface antigen (r = 0.484, 0.384 and 0.759, respectively). The serum miR-192-5p level was useful as a biomarker for the therapeutic efficacy of Peg-IFN in CHB treatment.

scholarly journals Predictors of inflammatory activity in treatment-naive hepatitis B e-antigen-negative patients with chronic hepatitis B infection

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096958
Author(s):  
Jianhua Hu ◽  
Yong Wang ◽  
Gongying Jiang ◽  
Jie Zheng ◽  
Tuxiang Chen ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Inflammatory Activity ◽  
Hepatitis B E Antigen ◽  
B Virus ◽  
Treatment Naïve

Objective Liver inflammatory activity staging is critical to guide the treatment of chronic hepatitis B virus (CHB) infection. Here, we aimed to identify practical clinical biomarkers of moderate inflammatory activity in hepatitis B e-antigen (HBeAg)-negative CHB patients. Methods Treatment-naïve HBeAg-negative CHB patients who underwent liver biopsy at our hospital from 1 January 2013 to 31 December 2016 were enrolled. Markers of inflammatory activity were analyzed using binary logistic regression. The area under the receiver operator characteristic curve (AUROCC) was used to assess diagnostic accuracy. Results A total of 106 HBeAg-negative treatment-naive CHB patients were enrolled. According to their METAVIR inflammatory scores, 30.2% of patients were in stage ≥A2. Total triiodothyronine (TT3) and hepatitis B virus (HBV) DNA levels were predictors of moderate inflammatory activity (A ≥ 2). The AUROCCs of TT3 and HBV DNA levels were 0.651 and 0.797, respectively. The optimal cut-off values for TT3 and HBV DNA were 1.755 nmol/L and 4.61 log10 IU/mL, respectively. Conclusions A sizable proportion of treatment-naive HBeAg-negative CHB patients required antiviral treatment (30.2%) after undergoing liver biopsy. TT3 and HBV DNA helps identify patients with moderate inflammatory activity (A ≥ 2), potentially reducing the need for liver biopsies and helping guide treatment of CHB patients.

Lamivudine and 24 weeks of lamivudine/interferon combination therapy for hepatitis B e antigen-positive chronic hepatitis B in interferon nonresponders

2003 ◽  
Vol 38 (6) ◽  
pp. 818-826 ◽  
Author(s):  
Eugene R Schiff ◽  
Jules L Dienstag ◽  
Selim Karayalcin ◽  
Ian S Grimm ◽  
Robert P Perrillo ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Combination Therapy ◽  
Chronic Hepatitis B ◽  
Hepatitis B E Antigen ◽  
Positive Chronic Hepatitis
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