Clearance and Seroconversion in Patients With HBeAg-Negative

Increasing Rates of HBsAg Clearance and Seroconversion in Patients With HBeAg-Negative Disease Treated With Peginterferon Alfa-2a ± Lamivudine: Results of 5-Year Post-Treatment Follow-up-- see attached full poster report

Presented at the 44th Annual Meeting of the European Association for the Study of the Liver (EASL), 22–24 April 2009, Copenhagen, Denmark
Reported by Jules Levin

Marcellin P,1 Piratvisuth T,2 Brunetto M,3 Bonino F,4 Lau GKK,5 Farci P,6 Yurdaydin C,7 Gurel S,8 Wu J,9 Popescu M10

1Service d’Hepatologie, Hôpital Beaujon APHP and Centre de Recherches Biologiques Bichat Beaujon (Inserm CRB3), University of Paris, Clichy France; 2NKC Institute of Gastroenterology and Hepatology, Department of Internal Medicine, Songklanagarind Hospital, Prince of Songkla University, Hat Yai 90110, Thailand; 3UO Gastreonterologia ed Epatologia, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy; 4Scientific Direction,
Foundation IRCCS Policlinico of Milan and University of Pisa, Italy; 5Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China; 6Universita di Cagliari, Cagliari, Italy; 7University of Ankara, Faculty of Medicine, Ankara, Turkey; 8Department of Gastroenterology, Uludag University, Turkey; 9Roche, Dee Why, Australia; 10F Hoffman-La Roche, Basel, Switzerland

Author Summary
Treatment with peginterferon alfa-2a ± lamivudine can induce biochemical and virologic response in around 20% of patients 5 years post-treatment, with HBV DNA levels below a threshold considered to be associated with a reduced risk of progressive liver disease

Importantly, the rate of HBsAg clearance in peginterferon alfa-2a-treated patients continued to increase during long-term follow-up, reaching 12% 5 years post-treatment highlighting that peginterferon alfa-2a is associated with a long-term durable posttreatment response

The rate of HBsAg clearance at year 5 in patients with HBV DNA ≤400 copies/mL was 72%

HBsAg decline during treatment was significantly greater in patients with HBsAg clearance, than in those who did not clear HBsAg. These results suggest that quantification of HBsAg might be a useful on-treatment predictor of long-term HBsAg response

Analysis of HBsAg decline in patients with genotype D suggests that the rate of decline is slower in patients with genotype D. However, the rate of HBsAg clearance achieved in HBV genotype D patients 5 years post-treatment was similar to that observed in the overall study population.

Conclusions
A finite course of peginterferon alfa-2a induces sustained responses in patients with HBeAg-negative CHB and, importantly, the rate of HBsAg clearance – the closest outcome to clinical cure of CHB – increases post-treatment.

The current analysis has shown that HBsAg decline during treatment is associated with long-term response suggesting that quantification of HBsAg during treatment may be used to predict long-term response to peginterferon alfa-2a-based therapy. Patients infected with genotype D are considered to be harder to treat than others, however, this analysis clearly demonstrates that these patients achieve similar HBsAg clearance rates response rates to the overall study population