back to 2011, vol. 17, b. 1

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2011, vol. 17, book 1
Subject Collection: Medicine
Page: 154-157
DOI: 10.5272/jimab.2011171.154
Online date: October 7, 2011

J of IMAB 2011; 17(1):154-157
Deian Jelev, Krasimir Antonov, Aneta Ivanova, Zahariy Krastev
Clinic of Gastroenterology, St. Ivan Rilsky University Hospital, Sofia, Bulgaria

Objective: IFN-based therapy induces long-term remission in ~20% of CHB-patients. Identification of predictors of treatment response can facilitate the clinical decision. 
Methods: 168 CHB-patients treated with IFN-based therapy were studied. Predictors of end-of-treatment response (ETR) and sustained response (SR) one-year post therapy were identified by non-parametric chi-square test and correlation analysis.
Results: Low baseline HBV DNA (<50,000,000 cp/ml) and high ALT level (>4xULN) were independent predictors of ETR. Low viral load was stronger predictor than high ALT level. If both factors coexist the probability of ETR was 92%. In HBeAg-negative subjects SR correlates significantly with age below 40 years, evidence of early viral response at 3rd month, fibrosis stage F<3 (METAVIR) and prolongation of treatment duration. HBeAg-seroconversion up to 6-month post-therapy was the strongest predictor of SR in HBeAg-positive patients.
Conclusion: More favorable results could be achieved by pretreatment selection according to patients’ age, baseline viral load, ALT and liver fibrosis. Extension of IFN-treatment in responders may enhance the SR rate.

Key words: HBV, IFN, Peg IFN, predictors, treatment.

- Download FULL TEXT (PDF - 217 KB)

1. Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004 Mar;11(2): 97–107. DOI: 10.1046/j.1365-2893.2003.00487.x CrossRef] [PubMed]
2. Bonino F, Rosina F, Rizzetto M, Rizzi R, Chiaberge E, Tardanico R, et al. Chronic hepatitis in HBsAg carriers with serum HBV-DNA and anti-HBe. Gastroenterology 1986 May;90(5Pt 1):1268–73. [PubMed]
3. Hadziyannis SJ. Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hep Rev 1995; 1:7–36.
4. Brunetto MR, Oliveri F, Coco B, Leandro G, Colombatto P, Gorin JM, Bonino F. Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study. J Hepatol. 2002 Feb;36(2):263–70. [PubMed]
5. Funk ML, Rosenberg DM, Lok ASF. World-wide epidemiology of HBeAg-negative chronic hepatitis B and associated precore and core promoter variants. J Viral Hepat. 2002 Jan;9(1):52–61. DOI: 10.1046/j.1365-2893.2002.00304.x  CrossRef] [PubMed]
6. Antonov А, Krastev Z.. HBeAg-negative chronic hepatitis B. Mod. Medicine 1998, 2, 42-43. (in Bulgarian)
7. Jelev D, Antonov K. Differences between HBeAg-positive and HBeAg-negative chronic hepatitis B. Bulgarian Hepatogastroenterology 2002, 3, 69-71. (in Bulgarian)
8. EASL.  Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol., 2009 Feb;50(2): 227 – 42. DOI: 10.1016/j.jhep.2008.10.001 CrossRef] [PubMed]
9. Perrillo RP, Schiff ER, Davis GL, Bodenheimer HC Jr, Lindsay K, Payne J, et al. A randomized, controlled trial of interferon alfa-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B. The Hepatitis Interventional Therapy Group. N Engl J Med 1990 Aug 2;323(5):295–301. [PubMed]
10. Lok AS, Wu PC, Lai CL, Lau JY, Leung EK, Wong LS, et al. A controlled trial of interferon with or without prednisone priming for chronic hepatitis B. Gastroenterology 1992 Jun;102(6):2091–7. [PubMed]
11. Buster EH, Hansen BE, Lau GK, Piratvisuth T, Zeuzem S, Steyerberg EW, Janssen HL. Factors that predict response of patients with hepatitis B e antigen-positive chronic hepatitis B to peginterferon-alfa. Gastroenterology. 2009 Dec;137(6):2002-9. Epub 2009 Sep 6. DOI: 10.1053/j.gastro.2009.08.061 CrossRef] [PubMed]
12. Brunetto MR, Oliveri F, Rocca G, Criscuolo D, Chiaberge E, Capalbo M, et al. Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen. Hepatology. 1989 Aug;10(2):198–202. [PubMed]
13. Oliveri F, Santantonio T, Bellati G, Colombatto P, Mels GC, Carriero L, et al. Long term response to therapy of chronic anti-HBe-positive hepatitis B is poor independent of type and schedule of interferon. Am J Gastroenterol. 1999 May;94(5):1366–72. DOI:10.1111/j.1572-0241.1999.01088.x CrossRef] [PubMed]
14. Manesis EK, Hadziyannis SJ. Interferon a treatment and retreatment of hepatitis B e antigen-negative chronic hepatitis B. Gastroenterology 2001 Jul;121(1):101–9. DOI: 10.1053/gast.2001.25524 CrossRef] [PubMed]
15. Bonino F, Marcellin P, Lau GK, Hadziyannis S, Jin R, Piratvisuth T, et al. Predicting response to peginterferon a-2a, lamivudine and the two combined for HBeAg - negative chronic hepatitis B. Gut 2007 May;56(5),699–705. DOI: 10.1136/gut.2005.089722 CrossRef] [PubMed]
16. Krastev Z, Tchernev K, Petrova D, Nikolovska D, Takov D, Marinova I, et al. Bulgarian Society of Gastroenterology. An open label, multicenter, national non-randomized study to evaluate efficacy and safety of Peginterferon alfa-2a (40 KD) in patients with HBeAg-negative chronic hepatitis B: preliminary results. Bulgarian Hepatogastroenterol. 2006; 2: 90–91. (in Bulgarian)
17. Tcherveniakova Т, Strashimirov D, Antonov K, Lilyanova V, Tiholova М, Krastev Z. НВV genotype in Bulgarian patients with acute viral hepatitis B. Bulgarian Hepatogastroenterology 2008, 2, 13 – 16. (in Bulgarian)
18. Lampertico P, Vigano M, Di Costanzo G, Sagnelli E, Fasano M, Di Marko V, Boninsegna S, Farci P, Fargion S, Giuberti T, Iannacone C, Massetto B, Fedeli P, Colombo M, Peg.B.e. Liver study Group. Extended (2 years) treatment with peginterferon alfa-2a (40KD) improves sustained response rates in genotype D patients with HBeAg-negative chronic hepatitis B. J Hepatol 2010; 52 (Suppl. 1): S45.

Please cite this article as: Jelev D, Antonov Kr, Ivanova A, Krastev Z. Predictors of sustained response to interferon-based therapy in chronic hepatitis B. J of IMAB 2011; 17(1):154-157. doi: 10.5272/jimab.2011171.154

back to Online Journal