Histological responses of peginterferon alpha add‐on therapy in patients with chronic hepatitis B with advanced liver fibrosis after long‐term nucleos(t)ide analog treatment

• Published in: Journal of viral hepatitis 2019-07, Vol.26 (S1), p.50-58
• Main Authors: Li, Guojun, Zhang, Qiran, Yu, Yiqi, Qiu, Chao, Zhang, Hanyue, Zhang, Miaoqu, Song, Zhangzhang, Yang, Yusheng, Hong, Jiemin, Lu, Jian, Li, Niuniu, Tang, Quanzhen, Xu, Long, Wang, Xuanyi, Zhang, Wenhong, Chen, Zhi
• Format: Article
• Language: English
• Subjects: Antigens; chronic hepatitis B; Cirrhosis; Fibrosis; Hepatitis; Hepatitis B e antigen; Hepatitis B surface antigen; histopathology; Interferon; Liver; Liver cirrhosis; nucleos(t)ide analog; peginterferon alpha; Remission; α-Interferon
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/jvh.13152

Although long‐term antiviral treatment with nucleos(t)ide analogs (NAs) can lead to histological improvement in patients with chronic hepatitis B (CHB), a substantial proportion of patients still fail to achieve regression of fibrosis. Here, we investigated whether peginterferon alpha (Peg‐IFNα） add‐on therapy had benefits on fibrosis regression in patients with sustained severe fibrosis even after long‐term NA treatment. We conducted a retrospective analysis of data from 50 patients with CHB receiving 48 weeks of Peg‐IFNα add‐on therapy. All enrolled patients had advanced fibrosis or cirrhosis (S score ≥ 3) at baseline and underwent NA treatment for at least 1 year before Peg‐IFNα addition. Paired liver biopsies before and after Peg‐IFNα add‐on treatment and laboratory tests at baseline, 24 weeks of treatment, 48 weeks of treatment and long‐term follow‐up were analysed. Of the 50 patients enrolled in this study, 34 patients (68.0%) had significant regression of fibrosis, and 42 (84.0%) showed significant remission of inflammation after Peg‐IFNα add‐on treatment. Compared with nonresponders, patients with significant histological improvement showed faster hepatitis B surface antigen (HBsAg) decline and tended to have higher cumulative hepatitis B e antigen (HBeAg) and HBsAg loss rates during long‐term follow‐up. Peg‐IFNα add‐on therapy led to significant regression of fibrosis and resolution of inflammation in patients with advanced fibrosis after long‐term NA treatment.