HBsAg clearance by Peg-interferon addition to a long-term nucleos(t)ide analogue therapy |
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Authors: | Michele Barone Andrea Iannone Alfredo Di Leo |
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Affiliation: | Michele Barone, Gastroenterology Unit, Department of Medical and Surgical Science, University of Foggia, 71122 Foggia, Italy;Andrea Iannone, Alfredo Di Leo, Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, 70124 Bari, Italy |
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Abstract: | The ideal endpoint of hepatitis B virus (HBV) antiviral therapy is HBsAg loss, a difficult goal to obtain, especially in HBeAg negative patients. Herein, we report the results obtained by the addition of peg-interferon α-2a to a long-lasting nucleos(t)ide analogue therapy in a HBeAg negative, genotype D patient with steadily HBV-DNA negative/HBsAg positive values. In 2002, our Caucasian 44-year-old male patient received lamivudine and, 4 years later, added adefovir because of a virological breakthrough. In 2011, considering his young age, liver stiffness (4.3 kPa) and HBsAg levels (3533 IU/mL), we added Peg-interferon α-2a for six months (3 in combination with nucleos(t)ide analogues followed by 3 mo of Peg-interferon α-2a monotherapy). A decrease of HBsAg levels was observed after 1 mo (1.21 log) of Peg-interferon and 3 mo (1.88 log) after the discontinuation of all drugs. Later, a complete clearance of HBsAg was obtained with steadily undetectable HBV-DNA serum levels (< 9 IU/mL). HBsAg clearance by the addition of a short course of Peg-interferon α-2a represents an important result with clinical and pharmaco-economic implications, considering that nucleos(t)ide analogues therapy in HBeAg negative chronic hepatitis B patients is considered a long-lasting/life-long treatment. |
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Keywords: | Addition HBeAg negative HBsAg clearance Nucleos(t)ide analogues Peg-interferon |
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