Treatment
with
PegInterferon
Alfa-2b:
HBsAg
Loss
Is
Associated
with
HBV
Genotype Loss
of
hepatitis
B surface
antigen
(HBsAg)
is
the
strongest
indicator
of
a complete
response
to
therapy
for
chronic
hepatitis
B,
including
normal
ALT
values
and
decreased
risk
for
liver
disease
and
liver
cancer
(hepatocellular
carcinoma).
In
the
current
study,
conducted
by
researchers
in
the
Department
of
Gastroenterology
and
Hepatology
at
UC
Rotterdam,
The
Netherlands,
7%
of
patients
treated
with
peginterferon
alfa-2b
(PegIntron)
monotherapy
achieved
loss
of
HBsAg
while
6%
experienced
HBsAg
seroconversion. Results
of
the
study
appear
in
the
current
issue
of
The
Journal
of
Gastroenterology
(February
2006). This
was
a multicenter
randomized
controlled
trial
in
which
266
HBeAg-positive
patients
were
treated
for
52
wks
with
PegIntron
100
microgram/wk
in
combination
with
either
lamivudine
[Epivir-HBV]
100
mg/day
or
placebo.
Results ·
At
the
end
of
the
26-week
follow
up,
95
(36%)
of
the
266
patients
experienced
HBeAg
loss,
18
(7%)
HBsAg
loss,
and
16
(6%)
HBsAg
seroconversion.
·
Addition
of
lamivudine
did
not
enhance
HBeAg
loss,
HBsAg
loss,
or
development
of
anti-HBs.
·
All
18
patients
who
showed
HBsAg
loss
had
normal
ALT;
11
(61%)
of
these
patients
were
also
hepatitis
B virus
(HBV)
DNA
negative
(<400
copies/mL)
at
the
end
of
follow-up.
·
Interestingly,
the
loss
of
HBsAg
differed
according
to
HBV
genotype:
14%
for
genotype
A,
9%
for
genotype
B,
3%
for
genotype
C,
and
2%
for
genotype
D.
Based
on
these
results,
the
authors
conclude,
“One
year
of
Peg-interferon
alfa-2b
for
HBeAg-positive
patients
led
to
HBsAg
loss
in
7%.
Our
study
indicates
that
treatment
with
Peg-interferon
α-2b
is
the
best
therapy
to
achieve
HBsAg
clearance
in
patients
with
genotype
A.” 02/24/06 Reference
H
J Flink
and
others
(for
the
HBV
99-01
Study
Group).
Treatment
with
Peg-Interferon
a-2b
for
HBeAg-Positive
Chronic
Hepatitis
B:
HBsAg
Loss
Is
Associated
with
HBV
Genotype.
The
American
Journal
of
Gastroenterology
101(2):
297-303.
February
2006.
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