Association Between HBeAg Seroconversion and Sustained HBV DNA Suppression in Patients Treated with Peginterferon Alfa-2a (40 KD) (Pegasys) for HBeAg-positive Chronic Hepatitis B
T Piratvisuth (Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Thailand) reported this study at EASL.
A large international randomized study1 has shown:
--significantly higher rates of HBeAg seroconversion and HBV DNA suppression 24 weeks post-treatment with peginterferon alfa-2a (Pegays) than lamivudine.
--HBsAg seroconversion only in those treated with Pegasys (alone or in combination), but not lamivudine
1. Lau et al. NEJM 2005.
Evidence from large cohort studies suggest that HBV DNA levels <104 cp/ml (10,000) are associated with a markedly reduced risk of cirrhosis and hepatocellular carcinoma. 1,2
We have investigated the relationship between HBeAg seroconversion and HBV DNA suppression in patients treated with Pegasys monotherapy.
1. Chen et al. JAMA 2006; 2. Iloeje et al. EASL 2005.
Patients achieving HBeAg seroconversion experienced a profound suppression in HBV DNA, which was sustained post-treatment.
2/3 of patients with HBeAg seroconversion had HBV DNA levels suppressed below 10,000 cp/ml
--79% among those with seroconversion occurring within the first 24 weeks of treatment
More profound and faster HBV DNA suppression is associated with 'early' HBeAg seroconversion and sutained HBV DNA suooression at the end of followup.
Pegasys-induced HBeAg seroconversion results in 2/3 of patients achieving sustained reductions in HBV DNA <104 copies/ml, a level which has been shown to be associated with a marked reduction in the risk of cirrhosis and hepatocellular carcinoma.2
2. Chen et al. JAMA 2006; 2. Iloeje et al. EASL 2005.
Patients with HBeAg-positive CHB were randomized using a 1:1:1 ratio