Peginterferon Alpha May Shorten Time to HBeAg Antigen Loss

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PEG-IFN add-on therapy may be considered when low HBsAg levels or HBeAg loss would be indicated to start a new therapeutic agent.
PEG-IFN add-on therapy may be considered when low HBsAg levels or HBeAg loss would be indicated to start a new therapeutic agent.

For patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B infection, the addition of peginterferon alpha (PEG-IFN) to entecavir (ETV) treatment after a short lead-in phase may accelerate HBeAg loss, according to results published in the Journal of Viral Hepatology.

After long-term follow up, rates of HBeAg loss become similar for patients treated with ETV plus PEG-IFN and ETV alone.

The study included participants who received ETV for more or less than 24 weeks of PEG-IFN add-on in a global trial (ARES study) and had at least 1 combined HBeAg and hepatitis B virus DNA measurement beyond week 96 of the ARES study. The primary end point was combined response (HBeAg loss and hepatitis B virus DNA <200 IU/mL) during long-term follow-up.

The researchers included 48 participants treated with PEG-IFN add-on and 48 participants treated with ETV monotherapy. The median follow-up duration was 226 weeks.

Of the 96 participants, 90% (n=86) were initial nonresponders. At long-term follow-up, 27% (n=13) of participants in the PEG-IFN add-on group had combined response compared with 23% (n=11) of those in the ETV monotherapy group (P =.81). In the PEG-IFN group, 59% of participants had 1 log10 HBsAg decline compared with 28% in the ETV group (P =.02).

Among 41 initial nonresponders who continued ETV therapy, 9 had combined response at long-term follow-up (5/22 in the PEG-IFN group, 4/19 in the ETV group).

After 96 weeks of follow-up, the researchers found that rates of serologic response became comparable between the PEG-IFN add-on group and the ETV monotherapy group.

“Although no recommendation towards the exact clinical application of PEG-IFN add-on as a strategy to increase HBeAg response or virological response can be made yet, this study may serve as a lead for exploring other pretreatment and add-on durations,” the researchers wrote.

Disclosures: Please refer to original text for full list of authors' disclosures.

Reference

van Campenhout MJH, Brouwer WP, Xie Q, et al. Long-term follow-up of patients treated with entecavir and peginterferon add-on therapy for HBeAg positive chronic hepatitis B infection: ARES long-term follow-up [published online September 10, 2018]. J Viral Hepat. doi:10.1111/jvh.12997

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