Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 28, 2016; 8(15): 637-643
Published online May 28, 2016. doi: 10.4254/wjh.v8.i15.637
Hepatitis B surface antigen clearance in inactive hepatitis B surface antigen carriers treated with peginterferon alfa-2a
Ming-Hui Li, Yao Xie, Lu Zhang, Yao Lu, Ge Shen, Shu-Ling Wu, Min Chang, Cai-Qin Mu, Lei-Ping Hu, Wen-Hao Hua, Shu-Jing Song, Shu-Feng Zhang, Jun Cheng, Dao-Zhen Xu
Ming-Hui Li, Yao Xie, Lu Zhang, Yao Lu, Ge Shen, Shu-Ling Wu, Min Chang, Cai-Qin Mu, Lei-Ping Hu, Jun Cheng, Dao-Zhen Xu, Liver Disease Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Wen-Hao Hua, Shu-Jing Song, Shu-Feng Zhang, Clinical Test Center, Beijing Ditan Hospital, Capital Medical University, Beijing100015, China
Author contributions: Li MH and Xie Y conceived the study, participated in the study design, and drafted the manuscript; Zhang L, Lu Y, Shen G, Wu SL, Chang M, Mu CQ and Hu LP supervised all aspects of the study implementation; the remaining authors coordinated testing and helped to draft the manuscript.
Institutional review board statement: The study was reviewed and approved by the Beijing Ditan Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There was no conflict of interest and this study was carried out as a part of our routine work.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yao Xie, PhD, Liver Disease Center, Beijing Ditan Hospital, Capital Medical University, 8 Jingshun East Street, Beijing 100015, China. xieyao00120184@sina.com
Telephone: +86-10-84322146 Fax: +86-10-84322146
Received: February 11, 2016
Peer-review started: February 12, 2016
First decision: March 9, 2016
Revised: April 6, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: May 28, 2016
Processing time: 98 Days and 2.3 Hours
Abstract

AIM: To examine the association between interferon (IFN) therapy and loss of hepatitis B surface antigen (HBsAg) in inactive HBsAg carriers.

METHODS: This was a retrospective cohort study in inactive HBsAg carriers, who were treatment-naive, with a serum HBsAg level < 100 IU/mL and an undetectable hepatitis B virus (HBV) DNA level (< 100 IU/mL). All the 20 treated patients received subcutaneous PEG-IFN alfa-2a 180 μg/wk for 72 wk and were then followed for 24 wk. There were 40 untreated controls matched with 96 wk of observation. Serum HBsAg, HBV DNA, and alanine aminotransferases were monitored every 3 mo in the treatment group and every 3-6 mo in the control group.

RESULTS: Thirteen (65.0%) of 20 treated patients achieved HBsAg loss, 12 of whom achieved HBsAg seroconversion. Mean HBsAg level in treated patients decreased to 6.69 ± 13.04 IU/mL after 24 wk of treatment from a baseline level of 26.22 ± 33.00 IU/mL. Serum HBV DNA level remained undetectable (< 100 IU/mL) in all treated patients during the study. HBsAg level of the control group decreased from 25.72 ± 25.58 IU/mL at baseline to 17.11 ± 21.62 IU/mL at week 96 (P = 0.108). In the control group, no patient experienced HBsAg loss/seroconversion, and two (5.0%) developed HBV reactivation.

CONCLUSION: IFN treatment results in HBsAg loss and seroconversion in a considerable proportion of inactive HBsAg carriers with low HBsAg concentrations.

Keywords: Chronic hepatitis B surface antigen carriers; Inactive hepatitis B surface antigen carriers; Interferon; Peginterferon alfa-2a; Hepatitis B surface antigen loss/seroconversion

Core tip: This study examined the association between interferon (IFN) therapy and loss of hepatitis B surface antigen (HBsAg) in inactive HBsAg carriers. This was a retrospective cohort study in inactive HBsAg carriers with a serum HBsAg level < 100 IU/mL and a persistently undetectable hepatitis B virus (HBV) DNA level (< 100 IU/mL). All the 20 treated patients received subcutaneous PEG-IFN alfa-2a 180 μg/wk for 72 wk and were then followed for 24 wk. IFN treatment resulted in HBsAg loss (65.0%) and seroconversion in a considerable proportion of inactive HBsAg carriers with low HBsAg concentrations. In the control group, no patient experienced HBsAg loss/seroconversion, and 2 (5.0%) developed HBV reactivation.