An evaluation on the efficacy and safety of peginterferon α-2b in nucleoside-treated patients with low serum level of HBsAg and compensated hepatitis B-related cirrhosis

Abstract

Abstract: Objective To explore the efficacy of pegylated interferon α-2b therapy in the treatment of low serum level of hepatitis B surface antigen (HBsAg) and compensated hepatitis B-related cirrhosis patients treated with nucleosides, and to analyze the safety. Methods From July 2018 to May 2022, eighty-four patients with compensated hepatitis B-related cirrhosis treated with nucleosides were selected and divided into a single drug group and a combination group. The combination group was treated with pegylated interferon α -2b combined with nucleosides, and the single drug group continued to treat with nucleosides for 48 weeks. The levels of alanine aminotransferase (ALT), total bilirubin (TBil), and HBsAg, HBsAg seroconversion rate, and negative conversion rate of HBsAg were compared between the two groups. The adverse drug reactions in both groups of patients were monitored. Results The ALT values at 24 weeks for the combination group and monotherapy group were (76.6±34.3) and (36.2±13.9) U/L, respectively, showing a significant difference (P<0.05). The quantitative HBsAg levels at 24 weeks and 48 weeks for the combination group were (482.8±317.2) and (258.8±227.9) U/L, respectively, both were lower than those of [(661.7±494.5) and (628.1±466.2) U/L] in the monotherapy group, with statistically significant differences (P<0.01). At 24 weeks, 6 patients (38.1%) in the combination group achieved HBsAg clearance, which was significantly higher than that of the monotherapy group (χ²=6.462, P=0.011). At 48 weeks, the rate increased to 38.1%, which was still significantly higher than that of the monotherapy group (χ²=22.909, P<0.01). The HBsAg seroconversion rate at 48 weeks in the combination group was 23.8%, which was significantly different from that of the monotherapy group (χ²=11.351, P<0.01). Regarding adverse reactions, the combination group experienced a reduction in white blood cells and platelets during the early stage of treatment, but these were tolerable, and they gradually recovered with continued treatment. All patients were able to complete the 48-week treatment regimen. Conclusion Peg-IFN-α-2b treatment in low-level HBsAg compensated HBV cirrhosis patients previously treated with NAs showed significance in HBsAg clearance rate and HBsAg serological conversion, with good tolerability and without severe adverse events in patients.

Key words: Peginterferon α-2b, Hepatitis B related cirrhosis, HBsAg clearance, Therapy

DAI Xue-feng, DING Ti-long, DING Ye-ying, MA Yan-chun. An evaluation on the efficacy and safety of peginterferon α-2b in nucleoside-treated patients with low serum level of HBsAg and compensated hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2025, 30(7): 926-929.

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