Long-term effect of interferon plus ribavirin on hepatitis B surface antigen seroclearance in patients dually infected with hepatitis B and C viruses
Journal
PLoS ONE
Journal Volume
6
Journal Issue
6
Pages
e20752
Date Issued
2011
Author(s)
Yeh M.-L.
Hung C.-H.
Huang J.-F.
Lee C.-M.
Dai C.-Y.
Wang J.-H.
Lin Z.-Y.
Lu S.-N.
Hu T.-H.
Yu M.-L.
Chuang W.-L.
Abstract
Background: Interferon-α/ribavirin combination therapy might promote hepatitis B surface antigen (HBsAg) seroclearance in patients dually infected with hepatitis B and C viruses (HBV/HCV), but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow-up after interferon-α/ribavirin combination therapy in HBV/HCV dually-infected patients. Methodology/Principal Findings: Eighty-one patients who received interferon-α/ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of-treatment, respectively. Fifteen (18.5%) patients had HBsAg seroclearance during a mean follow-up period of 3.4 (0.5-5.1) years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio (OR), 95% confidence intervals (CI) of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis. Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss (OR, 43.0; CI, 2.5-745). Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8.3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss. Conclusions: We demonstrated that interferon-α/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of-treatment were significant factors associated with HBsAg seroclearance. ? 2011 Yeh et al.
SDGs
Other Subjects
alpha interferon; biological marker; hepatitis B surface antigen; ribavirin; virus DNA; virus RNA; alpha interferon; ribavirin; virus DNA; adult; article; combination chemotherapy; controlled study; drug efficacy; drug response; female; follow up; hepatitis B; hepatitis C; human; liver cirrhosis; major clinical study; male; mixed infection; outcome assessment; prediction; seroconversion; serology; treatment duration; viral clearance; blood; clinical trial; demography; drug effect; hepatitis B; Hepatitis B virus; hepatitis C; Hepatitis C virus; middle aged; physiology; time; virology; Hepatitis B virus; Hepatitis C virus; Demography; DNA, Viral; Female; Follow-Up Studies; Hepacivirus; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis C; Humans; Interferon-alpha; Male; Middle Aged; Ribavirin; Time Factors
Publisher
Public Library of Science
Type
journal article