Noninvasive Liver Fibrosis Model In Predicting Efficacy Of Pegylated Interferon α Therapy For Patients With HBeAg-Positive Chronic Hepatitis B

Objective: To preliminary study the predictors of therapy response in HBe Ag-positive chronic hepatitis B patients with 48 weeks post-treatment of pegylated interferon α and discuss the value of noninvasive liver fibrosis model in predicting efficacy.Methods: Consecutively collecting the erological detection of HBe Ag-positive chronic hepatitis B patients with 48 weeks post-treatment of Peg-interferonαwere collected in our unitin a week before receiving treatment、the 12 th week of treatment、the 24 th week of treatment and at the end of treatment, some of them receive the pathological examination of liver tissue,then analysis the predictors of therapy response.Calculate the integral points of liver fibrosis in AP model、FIB-4 model、APRI model、APGA model and GP model, select the model that replaces pathological examination of liver tissue, then quantify the degree of liver fibrosis with the model.Discuss the value of noninvasive liver fibrosis model in predicting efficacy of Pegylated Interferon α Therapy.Results: A total of 113 HBe Ag-positive chronic hepatitis B patients with48 weeks post-treatment of Peg-interferonα(Peg-interferonα-2a and Peg-interferonα-2b)were enrolled in this study,associations between baseline characteristics and HBe Ag seroconversion at the end of treatment were explored by single factor analyses. By comparing 5 models, we selected APGA model to replace pathological examination of liver tissue. The result shows that sex(p=0.300)、age(p=0.919)、ALT(p=0.373)、AST(p=0.669)、ALB(p=0.981)、GLO(p=0.747)、GGT(p=0.645)、CHE(p=0.967)、PLT(p=0.226)、PT(p=0.541)、CP(0.224)、AFP(p=0.109)、HBV genotype(p=1.000) and the liver fibrosis quantification of APGA model(p=0.652).However there were associations between HBe Ag seroconversion and baseline HBV DNA(p=0.031)、HBs Ag(p=0.004) 、 HBe Ag(P<0.001),at the 12 th week of treatment HBV DNA(P<0.001)、HBs Ag(P=0.012)、HBe Ag(P<0.001),at the 24 th week of treatment HBV DNA(P=0.003)、HBs Ag(P=0.014)、HBe Ag(P<0.001)and the difference of HBV DNA between the baseline and the 12 th week(p=0.019) 、the difference of HBe Ag between the baseline and the 12 th week(P<0.001) 、the difference of HBe Ag between the baseline and the 24 h week(P<0.001).Multiple logistic regression analysis showed that HBe Ag at the 24 th week of treatment was the independent predictor of HBe Ag seroconversion(p<0.001). At the 12 th week of treatment,the integral points of liver fibrosis in AP model、FIB-4 model、GP model and the differences between them and the baselines were not associated with HBe Ag seroconversion(p>0.05).Conclusions: HBe Ag at the 24 th week of treatment was the independent predictor of HBe Ag seroconversion for HBe Ag-positive chronic hepatitis B patients with48 weeks post-treatment of Peg-IFN α. The noninvasive liver fibrosis model didn’t have the significant value of predicting efficacy of Pegylated Interferon α Therapy for Patients with HBe Ag-Positive Chronic Hepatitis B for 48 weeks.