Abstract | BACKGROUND/AIMS: To assess the HBsAg seroconversion rate and its impact on the long-term outcome in chronic hepatitis B patients treated with conventional interferon, and to analyze the serum HBsAg concentration prior to seroconversion. METHODS: Ninety-seven HBeAg-positive patients were retrospectively evaluated. Sustained virological response (SVR) was defined as HBeAg seroconversion and undetectable serum HBV- DNA 48 weeks after treatment discontinuation. HBsAg level was assessed at yearly intervals until seroconversion in SVRs. RESULTS: Twenty-five patients (26%) achieved SVR. By multivariate analysis, SVR was associated with low serum HBV DNA level and severe liver fibrosis. During a median follow-up of 14 years (range, 5-20 years), 28 patients (29%) developed HBsAg seroconversion including 16 SVRs (64%) and 12 non-SVRs (16%), p < 0.001. HBsAg quantification showed a major decrease (median = 46%, range = 19-100%) in the first year after interferon starting in SVR patients. Six patients developed hepatocellular carcinoma, none of them had undergone HBsAg seroconversion. Liver fibrosis improved in 70% of patients with HBsAg seroconversion compared to 30% of those without HBsAg seroconversion (p < 0.01). CONCLUSIONS:
HBsAg seroconversion is achieved with a high steady rate in patients responding to interferon, and associated with excellent outcome. Prospective studies are needed to clarify the utility of on-treatment quantitative serum HBsAg in interferon-based therapy.
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Authors | Rami Moucari, Anneke Korevaar, Olivier Lada, Michelle Martinot-Peignoux, Nathalie Boyer, Vincent Mackiewicz, Agnes Dauvergne, Ana C Cardoso, Tarik Asselah, Marie-Hélène Nicolas-Chanoine, Michel Vidaud, Dominique Valla, Pierre Bedossa, Patrick Marcellin |
Journal | Journal of hepatology
(J Hepatol)
Vol. 50
Issue 6
Pg. 1084-92
(Jun 2009)
ISSN: 1600-0641 [Electronic] Netherlands |
PMID | 19376603
(Publication Type: Journal Article)
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Chemical References |
- Antiviral Agents
- DNA, Viral
- Hepatitis B Antibodies
- Hepatitis B Surface Antigens
- Hepatitis B e Antigens
- Interferons
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Topics |
- Adult
- Aged
- Antiviral Agents
(therapeutic use)
- Carcinoma, Hepatocellular
(etiology)
- DNA, Viral
(blood)
- Female
- Follow-Up Studies
- Hepatitis B Antibodies
(blood)
- Hepatitis B Surface Antigens
(blood)
- Hepatitis B e Antigens
(blood)
- Hepatitis B virus
(immunology, isolation & purification, pathogenicity)
- Hepatitis B, Chronic
(complications, drug therapy, immunology, virology)
- Humans
- Interferons
(therapeutic use)
- Liver
(pathology)
- Liver Neoplasms
(etiology)
- Male
- Middle Aged
- Retrospective Studies
- Young Adult
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