Factors influencing the curative effect in patients with HBeAgpositive chronic hepatitis B treated with peg-interferon α-2a / 中南大学学报(医学版)

ABSTRACT

OBJECTIVE@#To investigate the factors that influence the curative effect in patients with HBeAgpositive chronic hepatitis B (CHB) treated with peg-interferon α-2a, and to explore whether such factors might predict the therapeutic effect.@*METHODS@#HBeAg-positive CHB patients treated with peg-interferon α-2a (180 μg once a week) were divided into a standard therapy group (48 weeks) and an extended therapy group (>48 weeks). The rates of HBsAg loss, HBeAg loss, HBeAg seroconversion, HBV DNA clearance, and ALT normalization were all evaluated in the two groups at the end of treatment and after 24 weeks follow up.@*RESULTS@#A total of 81 patients were enrolled in the study. The standard therapy group included 37 patients, and the extended therapy group included 44 cases, with durations ranging from 52 to 92 (median 72) weeks. The baseline clinical data were comparable between the two groups (P>0.05). At the end of treatment and at 24 weeks of follow-up, the HBeAg seroconversion rate of the extended therapy group was significantly higher than that of the standard therapy group (54.5% vs 29.7%, P=0.025, at 24 weeks; 76.9% vs 52.9%, P=0.008, after follow-up). In the standard therapy group, age and half-quantification of HBeAg at 24 weeks of treatment were the predictive factors for HBeAg seroconversion at 24 weeks of follow-up. Using a logistic regression model, the area under the receiver operating characteristic curve was 0.872, taking the optimum cut-off point of -1.299, with 100.0% sensitivity at 66.7% specificity. COX multi-factor analysis (of the two groups) showed that age and therapy duration were predictive factors for HBeAg seroconversion at 24 weeks of follow-up.@*CONCLUSION@#HBeAg-positive CHB patients treated with peg-interferon α-2a may have a better curative effect at a young age or with extended therapy. Age and half-quantification of HBeAg at 24 weeks of treatment may predict HBeAg seroconversion at 24 weeks of follow-up after completion of the standard therapy.