Peginterferon Alfa and TDF combo tied to earlier clearance of HBsAg

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-15T20:00:12+05:30 | Updated On 15 Jan 2023 8:00 PM IST

Protocolized peginterferon (PegIFN) with tenofovir disoproxil fumarate (TDF) followed by TDF withdrawal resulted in early HBsAg clearance, says a study published in the American Journal of Gastroenterology.

HBsAg loss is associated with improved long-term outcomes in patients with chronic hepatitis B, but it is infrequently achieved with current monotherapies. This randomized trial by Terrault, Norah and peers was aimed to assess whether combination strategies that included treatment withdrawal enhanced HBsAg loss in patients with chronic hepatitis B.

The study enrolled 201 participants and randomized them into two groups, one group received TDF alone, the other group received TDF plus PegIFN alfa-2a for the first 24 weeks, followed by withdrawal of TDF at week 192 with 48 weeks of off-treatment follow-up to week 240. The primary endpoint of the study was HBsAg loss at week 240.

The findings of the study were:

Of the 201 participants, 6 participants had lost HBsAg at the end of the treatment phase (week 192), 5 (5.3%) in the combination group, and 1 (1.0%) in the TDF alone group. By week 240, 9 participants had cleared HBsAg, 5.3% in the combination group, and 4.1% in the monotherapy group.

The study also found that HBsAg decline and loss occurred earlier with TDF + PegIFN than TDF alone, with a ≥1-logIU/mL qHBsAg decline by week 24 in 28% in TDF + PegIFN compared with 6% in TDF alone (P = 0.04).

The study also found that HBsAg loss was more frequent in patients with subgenotype A2 (58%) compared to the other genotypes (1%). And it also found that HBeAg positivity was a strong predictor for HBsAg clearance (8.6% vs 1.1%)

Source:

Terrault, N. A., Lok, A. S., Wahed, A. S., Ghany, M. G., Perrillo, R. P., Fried, M. W., Wong, D. K., Khalili, M., Lau, D. T. Y., Sterling, R. K., Di Bisceglie, A. M., Cooper, S. L., Chung, R. T., & Janssen, H. L. A. (2023). Randomized Trial of Tenofovir With or Without Peginterferon Alfa Followed by Protocolized Treatment Withdrawal in Adults With Chronic Hepatitis B. In American Journal of Gastroenterology: Vol. Publish Ahead of Print. Ovid Technologies. https://doi.org/10.14309/ajg.0000000000002125

American Journal of Gastroenterologyhepatitis B surface antigenpeginterferon

Source : American Journal of Gastroenterology

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751