Outcome of Chinese patients with hepatitis B at 96 weeks after functional cure with IFN versus combination regimens

Calvin Q. Pan, Ming Hui Li, Wei Yi, Lu Zhang, Yao Lu, Hong Xiao Hao, Gang Wan, Wei Hua Cao, Xing Yue Wang, Chong Ping Ran, Ge Shen, Shu Ling Wu, Min Chang, Yuan Jiao Gao, Yao Xie

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background & Aims: Nucleotides with add-on interferon treatment (NUC-IFN) provide significantly higher rates of hepatitis B surface antigen (HBsAg) loss in patients with chronic hepatitis B (CHB). This study aimed to investigate the sustainability of HBsAg loss and the prevention of clinical relapse. Methods: Patients with CHB who achieved HBsAg loss and HBV DNA levels <20 IU/ml after IFN or NUC-IFN therapy were enrolled and followed up for 96 weeks. The primary outcome was HBsAg negativity without viremia at week 96. Secondary outcomes included virological or clinical relapse and predictors of relapse. Results: 420 patients were included in intention-to-treat analysis with 290 and 130 in the IFN and NUC-IFN groups respectively. At week 96, the intention-to-treat analysis revealed similar outcomes between groups, including HBsAg seroreversion (24.83% vs. 23.08%, P =.70), viremia (16.90% vs 13.08%, P =.32) and clinical relapse (11.38% vs 10.00%, P =.68); the per-protocol analyses also showed HBsAg seroreversion, viremia and clinical relapse in IFN group (15.50%, 6.59% and 0.39%) did not differ from those in NUC-IFN group (15.25%, 4.24% and 0.85%, P >.05). These outcomes were similar between patients who received entecavir and those who received telbivudine/lamivudine/adefovir before the combination therapy. In NUC-IFN-treated patients, fibrosis regression was observed at week 96. Baseline HBsAb negativity was independent predictors of HBsAg sero-reversion and recurrence of viremia in IFN treated group. Conclusion: NUC-IFN and IFN therapies are equally effective in achieving sustained functional cure and fibrosis regression. (ClinicalTrials.gov, Number NCT02336399).

Original languageEnglish
Pages (from-to)1498-1508
Number of pages11
JournalLiver International
Volume41
Issue number7
DOIs
StatePublished - Jul 2021
Externally publishedYes

Keywords

  • HBsAg seroreversion
  • clinical relapse
  • hepatitis B flare
  • virological relapse

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