HBeAg
and HBV DNA Predict Outcomes of Pegylated Interferon Therapy for Chronic Hepatitis
B
In
a study described in the February 2008 issue of Hepatology, investigators
aimed to evaluate the usefulness of quantitative hepatitis B "e" antigen
(HBeAg) values for predicting HBeAg seroconversion in chronic
hepatitis B patients treated with pegylated
interferon alfa-2a (Pegasys). They also assessed dynamic changes in quantitative
HBeAg during therapy, compared with conventional measures of serum hepatitis B
virus (HBV) DNA.
Data were analyzed from a large, randomized, multinational
Phase 3 registration trial involving 271 HBV-infected HBeAg positive patients
who received pegylated interferon plus oral placebo for 48 weeks. HBeAg levels
were measured serially during therapy using an enzyme immunoassay.
Results
•
Among
patients who achieved HBeAg seroconversion, levels of HBeAg consistently decreased
during treatment.
•
HBeAg
remained at its lowest level during the 24 weeks of post-treatment follow-up.
•
After
24 weeks of treatment, 4% of patients with the highest HBeAg level (100 IU/mL
or greater) achieved HBeAg seroconversion, yielding a negative predictive value
of 96%.
•
This
was greater than the negative predictive value obtained for HBV DNA level (86%).
•
Late
responders could be differentiated from non-responders by continued decrease in
HBeAg values, but not by changes in HBV DNA.
Conclusion
Based
on these findings, the authors wrote, "These analyses suggest quantitative
HBeAg is a useful adjunctive measurement for predicting HBeAg seroconversion in
patients treated with peginterferon when considering both sensitivity and specificity
compared with serum HBV DNA."
2/19/08
Reference MW
Fried, T Piratvisuth, GK Lau, and others. HBeAg and hepatitis B virus DNA as outcome
predictors during therapy with peginterferon alfa-2a for HBeAg-positive chronic
hepatitis B. Hepatology 47(2): 428-434. February 2008.
