Gut Liver.  2016 Jul;10(4):611-616. 10.5009/gnl14256.

Potential Efficacy of Pegylated Interferon-α and a Nucleos(t)ide Analogue as Combination Therapy for HBeAg-Positive Chronic Hepatitis B

• Wi CI
• Kim WR
• Gross JB
• Stadheim L
• Poterucha

• KMID: 2412051
• DOI: http://doi.org/10.5009/gnl14256

Abstract

BACKGROUND/AIMS
Despite the potent suppression of the hepatitis B virus with modern antiviral agents, only a minority of HBeAg-positive patients achieve hepatitis B e antigen seroconversion. We aimed to explore the potential efficacy of combination therapy consisting of pegylated interferon (p-IFN) and an oral antiviral agent in patients with HBeAg-positive chronic hepatitis B.
METHODS
The treatment protocol consisted of p-IFN-α-2a at 180 μg/wk for 48 weeks, with either entecavir or tenofovir added 8 weeks after the initiation of p-IFN and continued for at least 6 months after HBe seroconversion was achieved.
RESULTS
To date, 10 patients have been treated under the protocol (eight adults, mean age 36±8 years; two adolescents, aged 12 and 16 years). All eight adult patients experienced loss of HBeAg at a mean of 72.3±66.9 weeks, including six patients who also developed anti-HBe and one patient who had HBs seroconversion. Although both adolescents remain on therapy, one adolescent had HBs seroconversion without HBe seroconversion. A total of nine of our 10 patients experienced a favorable serological transition.
CONCLUSIONS
The combination of p-IFN and a modern oral antiviral agent may be more effective than monotherapy with either class of agent in the treatment of HBeAg-positive chronic hepatitis B patients.

Keyword

Combination antiviral therapy; HBeAg-positive chronic hepatitis B; HBe seroconversion; Pegylated interferon; Entecavir or tenofovir

MeSH Terms

Adolescent
Adult
Antiviral Agents/*therapeutic use
Drug Therapy, Combination
Female
Guanine/*analogs & derivatives/therapeutic use
Hepatitis B e Antigens/metabolism
Hepatitis B, Chronic/*drug therapy
Humans
Interferon-alpha/*therapeutic use
Male
Middle Aged
Polyethylene Glycols/*therapeutic use
Recombinant Proteins/therapeutic use
Tenofovir/*therapeutic use
Treatment Outcome
Antiviral Agents
Hepatitis B e Antigens
Interferon-alpha
Recombinant Proteins
Polyethylene Glycols
Guanine
Tenofovir