Clinical Efficacy Analysis And Prediction Of Pegylated Interferon In Nucleoside Analogue Experienced Negative HBeAg Chronic Hepatitis B

Objective : To analysis Hepatitis B surface antigen(HBs Ag)clearance and seroconversion and predictive value of PD-1/IL-28 B gene polymorphisms about pegylated interferon in nucleoside analogues(NAs)experienced or continuous NAs monotherapy negative HBe Ag chronic Hepatitis B(CHB).Methods:In this retrospective study,133 negative HBe Ag CHB patients who started treatment with either pegylated interferon add-on therapy(n=73)or continuous NAs monotherapy(n=60)were selected in the Department of infectious Diseases,Central South University Xiangya Hospital from January 1,2020 to October 30,2021.HBs Ag clearance and seroconversion rate and related influencing factors at 12 th week 24 th week and 48 th week of treatment were analyzed.Patients were followed up to72 th weeks to observe the persistent response and recurrence.In addition,blood samples of 24 patients with the same inclusion criteria were collected to analyze the correlation between SNP polymorphism of IL-28 and PD-1in interferon treatment.Results: After 12 weeks treatment,HBs Ag clearance was achieved in6 patients in the combined treatment group.At the 24 th week of treatment,24 patients achieved HBs Ag clearance in the combined treatment.At the48 th week of treatment,HBs Ag clearance occurred in 38(38/73)patients in the combined therapy group and 1(1/60)patients in the NAs group.The difference in HBs Ag clearance between two groups was statistically significant(P < 0.01).HBs Ag decreased in the 24 th week(OR=9.062,95%CI=2.767,29.673,P<0.01)and HBs Ag baseline level(OR=0.996,95%CI=0.994,0.999,P < 0.01)have statistically significant differences in48 th HBs Ag clearance.HBs Ag clearance rate at 48 th week between HBs Ag < 100IU/m L and ≥1000IU/m L groups was statistically significant(P < 0.01).The proportion of PD-1 RS10204525 C/T heterozygous mutant in the response group was significantly higher than that in the non-response group(66.7% vs.33.3%,P < 0.05),while there was no significant difference in gene frequency of IL-28 B SNP between the two groups.Conclusion: 1.NAs experienced HBe Ag-negative CHB patients can achieve higher HBs Ag clearance rate and seroconversion rate by pegylated interferon add-on therapy.2.HBs Ag level decline at 24 th week can predict clinical efficacy of48 th week.3.Patients with HBs Ag levels < 100IU/m L were more likely to have HBs Ag clearance than patients with HBs Ag levels ≥1000IU/m L.4.Patients with the C/T heterozygous mutation of PD-1 rs10204525 were more likely to have benefits from interferon therapy than patients with the TT homozygous gene.