Comparison between quantitative hepatitis B surface antigen, hepatitis B e-antigen and hepatitis B virus DNA levels for predicting virological response to pegylated interferon-α-2b therapy in hepatitis B e-antigen-positive chronic hepatitis B
Article first published online: 11 JAN 2010
© 2010 The Japan Society of Hepatology
Volume 40, Issue 3, pages 269–277, March 2010
How to Cite
Tangkijvanich, P., Komolmit, P., Mahachai, V., Sa-nguanmoo, P., Theamboonlers, A. and Poovorawan, Y. (2010), Comparison between quantitative hepatitis B surface antigen, hepatitis B e-antigen and hepatitis B virus DNA levels for predicting virological response to pegylated interferon-α-2b therapy in hepatitis B e-antigen-positive chronic hepatitis B. Hepatology Research, 40: 269–277. doi: 10.1111/j.1872-034X.2009.00592.x
- Issue published online: 26 FEB 2010
- Article first published online: 11 JAN 2010
- Received 22 May 2009; revision 8 July 2009; accepted 27 July 2009.
- covalently closed circular DNA;
- hepatitis B e-antigen;
- hepatitis B surface antigen;
- hepatitis B virus DNA;
- pegylated interferon;
- virological response
Aim: The aim of this study was to compare the clinical applicability of quantitative serum hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg) and hepatitis B virus (HBV) DNA for predicting virological response (VR) to pegylated interferon (PEG-IFN) therapy.
Methods: Thirty HBeAg-positive chronic hepatitis B patients who received PEG-IFN-α-2b for 48 weeks were enrolled. Quantitative HBsAg, HBeAg and HBV DNA were measured before, during and after the therapy. Paired liver biopsies were performed before and after treatment for covalently closed circular (ccc)DNA and intrahepatic HBV DNA analysis.
Results: VR at 48 weeks post-treatment, defined as HBeAg seroconversion and HBV DNA less than 10 000 copies/mL was achieved in 10 (33.3%) patients. Responders had significantly lower baseline HBsAg, HBeAg, cccDNA and intrahepatic HBV DNA levels than non-responders. Baseline and reduced levels of log10 HBsAg and log10 HBeAg correlated well with those of log10 cccDNA and log10 total intrahepatic HBV DNA. Responders showed consistent decrease in serum HBsAg, HBeAg and HBV DNA levels during therapy. HBeAg level of 2.0 log10 sample to cut-off ratio at week 24 on therapy provided the best prediction of sustained virological response, with sensitivity and negative predictive values of 85% and 92%, respectively. One patient (3.3%) who cleared HBsAg at follow up exhibited a more rapid decline in serum HBsAg during therapy than those who developed VR without HBsAg clearance.
Conclusion: 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.