AI Article Synopsis
- The study examines how well pegylated interferon (PEG-IFNα) therapy can clear hepatitis B surface antigen (HBsAg) in chronic hepatitis B (CHB) patients and identifies factors predicting successful treatment.
- A systematic review of 102 studies shows low overall HBsAg clearance rates, around 10.6% at the end of treatment and 11.1% after follow-up, with baseline HBsAg levels being the most critical predictor.
- Higher baseline HBsAg levels (like 100 IU/ml) lead to significantly better clearance rates (up to 53.9%) compared to higher levels (like 10,000 IU/ml, which is only 7.9%), and
Article Abstract
Background And Aims: The efficacy of achieving HBsAg clearance through pegylated interferon (PEG-IFNα) therapy in patients with chronic hepatitis B (CHB) remains uncertain, especially regarding the probability of achieving functional cure among patients with varying baseline HBsAg levels. We aimed to investigate the predictive value of HBsAg quantification for HBsAg seroclearance in CHB patients undergoing PEG-IFNα treatment.
Methods: A systematic search was conducted in PubMed, Embase, and the Cochrane Library up to January 11, 2022. Subgroup analyses were performed for HBeAg-positive and HBeAg-negative patients, PEG-IFNα monotherapy and PEG-IFNα combination therapy, treatment-naive and treatment-experienced patients, and patients with or without liver cirrhosis.
Results: This predictive model incorporated 102 studies. The overall HBsAg clearance rates at the end of treatment (EOT) and the end of follow-up (EOF) were 10.6% (95% CI 7.8-13.7%) and 11.1% (95% CI 8.4-14.1%), respectively. Baseline HBsAg quantification was the most significant factor. According to the model, it is projected that when baseline HBsAg levels are 100, 500, 1500, and 10,000 IU/ml, the HBsAg clearance rates at EOF could reach 53.9% (95% CI 40.4-66.8%), 32.1% (95% CI 24.8-38.7%), 14.2% (95% CI 9.8-18.8%), and 7.9% (95% CI 4.2-11.8%), respectively. Additionally, treatment-experienced patients with HBeAg-negative status, and without liver cirrhosis exhibited higher HBsAg clearance rates after PEG-IFNα treatment.
Conclusion: A successful predictive model has been established to predict the achievement of functional cure in CHB patients receiving PEG-IFNα therapy.
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| http://dx.doi.org/10.1007/s12072-024-10666-6 | DOI Listing |
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