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Predictive models for functional cure in patients with CHB receiving PEG-IFN therapy based on HBsAg quantification
Pei-Xin Zhang1, Qian-Qian Tang1, Jie Zhu1
1Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
Hepatology International
|June 24, 2024
Summary
Predicting functional cure in chronic hepatitis B (CHB) is possible using baseline Hepatitis B surface antigen (HBsAg) levels. Lower HBsAg levels significantly increase the probability of HBsAg clearance with pegylated interferon-alfa (PEG-IFNα) therapy.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B (CHB) poses a significant global health challenge.
- Achieving Hepatitis B surface antigen (HBsAg) clearance is a key goal for functional cure in CHB patients.
- The predictive role of baseline HBsAg levels for treatment outcomes with pegylated interferon-alfa (PEG-IFNα) remains an area of active investigation.
Purpose of the Study:
- To investigate the predictive value of baseline HBsAg quantification for achieving HBsAg seroclearance in CHB patients undergoing PEG-IFNα treatment.
- To establish a predictive model for functional cure in CHB patients treated with PEG-IFNα.
- To assess the impact of various patient subgroups on HBsAg clearance rates.
Main Methods:
- A systematic literature search was performed across PubMed, Embase, and the Cochrane Library.
- Data from 102 studies were incorporated into a predictive model.
- Subgroup analyses were conducted based on HBeAg status, treatment type, treatment history, and presence of liver cirrhosis.
Main Results:
- Overall HBsAg clearance rates were 10.6% at the end of treatment and 11.1% at the end of follow-up.
- Baseline HBsAg quantification emerged as the most significant predictor of HBsAg clearance.
- Projected HBsAg clearance rates at end of follow-up varied significantly with baseline HBsAg levels (e.g., 53.9% for 100 IU/ml vs. 7.9% for 10,000 IU/ml).
- Treatment-experienced, HBeAg-negative patients without cirrhosis showed higher clearance rates.
Conclusions:
- A robust predictive model for functional cure in CHB patients receiving PEG-IFNα therapy has been developed.
- Baseline HBsAg levels are crucial for predicting treatment success.
- The model can aid in personalizing treatment strategies for CHB patients.
