To evaluate the usefulness of quantitative hepatitis B e antigen (HBeAg) values for predicting HBeAg seroconversion in patients treated with peginterferon alfa-2a, Fried et al.1 analyzed 271 patients infected with hepatitis B virus (HBV) who were HBeAg-positive and who received peginterferon alfa-2a plus oral placebo for 48 weeks, and found that quantitative HBeAg is a useful adjunct measurement for predicting HBeAg seroconversion in patients treated with peginterferon when considering both sensitivity and specificity compared with serum HBV DNA. As we know, HBeAg and HBV DNA are not independent variables, so when we used the level of HBeAg at week 12 or 24 to predict the rate of HBeAg seroconversion at week 72, the level of HBV DNA for those patients should be analyzed. For example, were the levels of HBV DNA similar between patients with different levels of HBeAg (<10 Paul Ehrlich Institute unit [PEIU]/mL, 10-100 PEIU/mL, and >100 PEIU/mL)? If not, the conclusions obtained from this study should be verified further. In addition, the author described that HBV DNA was measured using in vitro nucleic acid amplification using the Cobas Amplicor HBV Monitor, with a working range of 400 (lower limit of detection) to 40,000,000 copies/mL, but in Fig. 3B of the result, it was showed the level of HBV DNA was divided into three grades (<5log10, 5-9 log10, and >9 log10). We hope the authors could clarify this issue.
To the Editor:
En-Qiang Chen M.D.*, Hong Tang M.D.*, * Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.