The Correlation Between The Viral Dynamics And Therapeutic Effectiveness In Patients With Chronic Hepatitis B During Therapy With Peginterferon Alfa-2a

ObjectiveTo analyze the correlation between the viral dynamics and therapeutic effectiveness in patients with chronic hepatitis B during therapy with peginterferon alfa-2a.MethodsCases of chronic hepatitis B included were treated with peginterferon alfa-2a for 48 weeks. The serum level of HBV DNA, HBsAg, HBeAg, HBeAb and ALT were tested at baseline and at 12,24,36,48 weeks during treatment. With these data, the viral dynamic change and its relationship with therapeutic effectiveness were analyzed. The significance of the viral dynamics as a predictor of virological response, serological response and biochemical response at the end of treatment was evaluated.Results1. Seventy patients were included. At the end of treatment, thirty-nine (55.7%) achieved biochemical response, thirty-seven (52.8%) achieved virological response, fourteen achieved seroconversion of HBeAg (33.3% of all HBeAg-positive patients), nineteen (27.1%) patients achieved complete response. Three cases (4.28%) ended up with clearance of HBsAg.2. At the end of treatment, the probability of complete response was higher in females (53.3%) than males (20.0%). The rate of females is 2.7 times higher than the males.3. There are three patterns of HBV dynamics:rapid decline type(16,22.9%),slow decline type (35,50.0%)and consistant fluctuating type(19,27.1%), respectively. Chances of biochemical and serological response of HBeAg didn't differ. The probability of virological response was higher in rapid and slow decline type than consistant fluctuating type. And the probability of complete response was higher in rapid decline type than consistant fluctuating type.4. The patterns of seroconversion were devided as the early seroconversion type, end-point seroconversion type, no seroconversion type. The number of the former two types and its proportion in all HBeAg-positive patients were 4.8%(two patients), 28.6%(twelve patients), respectively.Conlusion1. There are three patterns of HBV dynamics:slow decline type, rapid decline type and consistent fluctuating type.2. The probability of virological response was higher in rapid and slow decline type than consistent fluctuating type. Rapid decline pattern of viral dynamics may predict a higher probability of complete response. So rapid decline type can be used as a predictor of end-point virological response and complete response.