Preliminary Study On The Efficacy Of Switching To Interferon Alpha In Chronic Hepatitis B Patients With Low HBsAg Levels By Nucleot(s)ide Analogues Treatment

Objective: To investigate the efficacy of switching to interferon alpha(IFN?)in hepatitis B e antigen(HBeAg)-negative patients receiving nucleos(t)ide analogues(NAs)with undetectable serum HBV-DNA and low hepatitis B surface antigen(HBsAg)levels.Methods: HBeAg-negative patients with HBV-DNA fully suppressed(HBV-DNA<1000 copies/ml for at least 12 months)and low HBs Ag levels(HBsAg?2000 IU/ml)by long-term NAs treatment,receiving a 48 weeks course of IFN? sequential to the backbone NAs regimens,were retrospectively included.Serum HBV DNA load,HBV markers,liver function and routine blood were detected before and every 3 months during treatment.Followed up for 24 weeks after treatment,the primary endpoint was HBsAg loss or seroconversion 48 and HBsAg<10 IU/ml.Correlation factors were analyzed using logistic regression.Receiver operating characteristics curve was used to identify the predictive value of HBeAg seroconversion history and on-treatment HBsAg dynamics on HBsAg loss.Results: 83 patients were included in the study.Withdrawal at 24 weeks,15(18.1%)patients achieved HBsAg loss,5(6.0%)patients received HBs Ag seroconversion,9(10.8%)patients achieved HBsAg<10 IU/ml.The proportion of patients with a history of HBeAg seroconversion spontaneously in HBsAg loss group was higher than HBsAg did not loss group(87%vs43%,X2=9.527,P=0.002).The history of HBeAg seroconversion was independently associated with HBs Ag loss after treatment(OR: 0.105,95%CI: 0.016-0.712,P=0.021).Patients with an HBs Ag decline from baseline at week 12 ?0.5 log IU/ml can achieve a higher response rate(47.6%vs8.1%,X2=16.576,P=0.000).The combination of a history of HBeAg seroconversion spontaneously and HBs Ag decline at week 12 ?0.5 log IU/ml provided the highest rate of HBs Ag loss(72.7%)after treatment.Conclusions: HBeAg-negative patients with a low HBsAg level by NAs treatment switched to IFN ? are more likely to achieve HBsAg clearance.HBs Ag loss can be predicted by the history of HBeAg seroconversion and on-treatment HBsAg dynamics.