Publication:
Treatment outcomes and validation of the stopping rule for response to peginterferon in chronic hepatitis B: A Thai nationwide cohort study

Issued Date

2016-11-01

Resource Type

Article

ISSN

14401746
08159319

DOI

10.1111/jgh.13378

Other identifier(s)

2-s2.0-84996565533

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of Gastroenterology and Hepatology (Australia). Vol.31, No.11 (2016), 1874-1881

Suggested Citation

Phunchai Charatcharoenwitthaya, Wattana Sukeepaisarnjaroen, Teerha Piratvisuth, Satawat Thongsawat, Theeranun Sanpajit, Soonthorn Chonprasertsuk, Woramon Jeamsripong, Ekawee Sripariwuth, Piyawat Komolmit, Tanisa Patcharatrakul, Rattana Boonsirichan, Chalermrat Bunchorntavakul, Supoj Tuntipanichteerakul, Tawesak Tanwandee Treatment outcomes and validation of the stopping rule for response to peginterferon in chronic hepatitis B: A Thai nationwide cohort study. Journal of Gastroenterology and Hepatology (Australia). Vol.31, No.11 (2016), 1874-1881. doi:10.1111/jgh.13378 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/41039

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Title

Treatment outcomes and validation of the stopping rule for response to peginterferon in chronic hepatitis B: A Thai nationwide cohort study

Author(s)

Phunchai Charatcharoenwitthaya
 Wattana Sukeepaisarnjaroen
 Teerha Piratvisuth
 Satawat Thongsawat
 Theeranun Sanpajit
 Soonthorn Chonprasertsuk
 Woramon Jeamsripong
 Ekawee Sripariwuth
 Piyawat Komolmit
 Tanisa Patcharatrakul
 Rattana Boonsirichan
 Chalermrat Bunchorntavakul
 Supoj Tuntipanichteerakul
 Tawesak Tanwandee

Other Contributor(s)

Mahidol University
 Khon Kaen University
 Prince of Songkla University
 Chiang Mai University
 Phramongkutklao College of Medicine
 Faculty of Medicine, Thammasat University
 Buddhachinaraj Hospital
 Naresuan University
 Chulalongkorn University
 Police General Hospital
 Vajira Hospital
 Rajavithi Hospital
 Bhumibol Adulyadej Hospital

Abstract

© 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd Background and Aims: Peginterferon has demonstrated effectiveness in clinical trials in patients with chronic hepatitis B (CHB). However, its efficacy in real-life settings remains unclear. We investigated the efficacy of peginterferon for CHB and validated the performance of previously identified response predictors in clinical practice. Methods: We analyzed prospectively collected data from a Thai nationwide cohort of CHB patients treated with peginterferon alfa-2a (180 µg/week, 48 weeks). Results: Among a total of 233 patients, mostly with genotype B or C, sustained response was observed in 23% of 135 hepatitis B e antigen (HBeAg)-positive patients (HBeAg seroconversion with hepatitis B virus [HBV] DNA < 2000 IU/mL) and 42% of 98 HBeAg-negative patients (HBV DNA < 2000 IU/mL with aminotransferase normalization) at 24 weeks after treatment. Age, sex, presence of cirrhosis, genotype, and pretreatment levels of aminotransferase, HBV DNA, and hepatitis B surface antigen (HBsAg) were not identified as significant predictors of sustained response. In HBeAg-positive patients, HBsAg > 20 000 IU/mL at week 12 provided a good stopping rule, with a negative predictive value of 96%. In HBeAg-negative patients, the performance of 12-week stopping rules of no decline in HBsAg with a < 2log10 decline in HBV DNA and a < 10% log10 decline in HBsAg showed modest negative predictive values of 80% and 66%, respectively, for achieving sustained response. Conclusion: Outcomes in CHB patients treated with peginterferon in a clinical setting are similar to those demonstrated in clinical trials. Application of the early stopping rule based on HBsAg quantification may allow individualization of therapy, particularly in HBeAg-positive patients.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/41039

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Scopus 2016-2017