Pisit
Tangkijvanich from Chulalongkorn University in Bangkok and colleagues
compared the clinical applicability of 3 serological measures
for predicting virological response to pegylated interferon
among patients with hepatitis B: HBsAg, HBeAg, and HBV DNA (viral
load).
The
study included 30 initially HBeAg positive chronic hepatitis
B patients who received pegylated
interferon alfa-2b (PegIntron) for 48 weeks. Quantitative
HBsAg, HBeAg, and HBV DNA were measured before, during, and
after therapy. In addition, paired before and after liver biopsies
were analyzed for the presence of intrahepatic HBV DNA and covalently
closed circular DNA (cccDNA).
Virological
response was defined as both HBeAg seroconversion and HBV DNA
< 10 000 copies/mL at 48 weeks after completion of treatment.
Results
 |
10
participants (33.3%) achieved virological response by both
criteria at 48 weeks post-treatment. |
|
Responders
had significantly lower baseline levels of HBsAg, HBeAg,
intrahepatic HBV DNA, and cccDNA compared with non-responders. |
|
Baseline
and reduced levels of HBsAg and HBeAg correlated well with
those of total intrahepatic HBV DNA and cccDNA. |
|
Responders
showed consistent decreases in serum levels of HBsAg, HBeAg,
and HBV DNA during therapy. |
|
An
HBeAg decrease of at least 2-fold at week 24 of therapy
was the best predictor of sustained virological response. |
|
Sensitivity
of 24-week HBeAg was 85% and negative predictive value was
92%. |
|
1
participant (3.3%) who achieved HBsAg clearance at follow-up
experienced more rapid decline in serum HBsAg during therapy
than those who achieved virological response without HBsAg
clearance. |
Based on these findings, the study authors concluded, "Quantitative
measurement of serum HBeAg during therapy may be superior to
serum HBsAg and HBV DNA as a prediction of HBeAg seroconversion."
"Kinetics
of HBsAg levels on therapy may help predict HBsAg clearance
after treatment," they suggested.
Department of Biochemistry, Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand; Departments of Biochemistry and
Medicine and Center of Excellence in Clinical Virology, Department
of Pediatrics, Faculty of Medicine, Chulalongkorn University,
Bangkok, Thailand.
6/4/10
Reference
P Tangkijvanich, P Komolmit, V Mahachai, and others. Comparison
between quantitative hepatitis B surface antigen, hepatitis
B e-antigen and hepatitis B virus DNA levels for predicting
virological response to pegylated interferon-alpha-2b therapy
in hepatitis B e-antigen-positive chronic hepatitis B. Hepatology
Research 40(3): 237-345 (Abstract).
March 2010.
