Short-term Peginterferon-Induced High Functional Cure Rate in Inactive Chronic Hepatitis B Virus Carriers With Low Surface Antigen Levels

Qing-Lei Zeng, Zu-Jiang Yu, Jia Shang, Guang-Hua Xu, Chang-Yu Sun, Na Liu, Chun-Xia Li, Jun Lv, Yan-Min Liu, Hong-Xia Liang, Zhi-Qin Li, Ya-Jie Pan, Qiu-Yue Hu, Wei Li, Da-Wei Zhang, Fu-Sheng Wang, Qing-Lei Zeng, Zu-Jiang Yu, Jia Shang, Guang-Hua Xu, Chang-Yu Sun, Na Liu, Chun-Xia Li, Jun Lv, Yan-Min Liu, Hong-Xia Liang, Zhi-Qin Li, Ya-Jie Pan, Qiu-Yue Hu, Wei Li, Da-Wei Zhang, Fu-Sheng Wang

Abstract

Background: None of the current guidelines recommend antiviral therapy for inactive hepatitis B virus (HBV) carriers (IHCs).

Methods: In this real-world, multicenter, nonrandomized study, 32 participants meeting the inclusion criteria were enrolled 1:1 for treatment with peginterferon α-2b or monitoring without treatment based on participant preference. The expected treatment duration was 48 weeks. The primary end point was hepatitis B surface antigen (HBsAg) loss. The HBV vaccine could be injected after HBsAg loss.

Results: All patients had HBsAg levels of <20 IU/mL. The mean baseline HBsAg levels were 6.6 IU/mL and 5.8 IU/mL in the treated and untreated groups, respectively. Fifteen (93.8%) participants achieved HBsAg loss, 5 obtained HBsAg seroconversion after undergoing a mean of 19.7 weeks of therapy in the treated group, and no one in the follow-up group achieved HBsAg loss during a mean follow-up time of 12.6 months (P < .0001). Generally, the therapy was well tolerated. Nine of 11 individuals who exhibited HBsAg loss benefited from receiving the HBV vaccine.

Conclusions: This study provides justification for further studies of short-course peginterferon α-2b for the functional cure of IHCs with low HBsAg levels. Additionally, HBV vaccine injection is beneficial after interferon-induced HBsAg loss.

Keywords: functional cure; hepatitis B surface antigen loss; hepatitis B vaccine; inactive hepatitis B virus carrier; peginterferon α-2b.

© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Cumulative rates of HBsAg loss from initiation of the study. Differences in the rate of HBsAg loss between the treated group (blue line) and the untreated follow-up group (red line) were determined using the log-rank test (P < .0001). Abbreviation: HBsAg, hepatitis B virus surface antigen.

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