High rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients responding to interferon: a long-term follow-up study.

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.

• 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)

Chemical References

• Antiviral Agents
• DNA, Viral
• Hepatitis B Antibodies
• Hepatitis B Surface Antigens
• Hepatitis B e Antigens
• Interferons

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