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Relapse after treatment with peginterferon α-2b alone or in combination with lamivudine in HBeAg positive chronic hepatitis B
  1. H J Flink1,
  2. E H C J Buster1,
  3. I Merican2,
  4. F Nevens3,
  5. G Kitis4,
  6. J Cianciara5,
  7. R A de Vries6,
  8. B E Hansen7,
  9. S W Schalm8,
  10. H L A Janssen8
  1. 1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
  2. 2Hospital Selayang, Institute for Medical Research, Kuala Lumpur, Malaysia
  3. 3Department of Hepatology, University Hospital Gasthuisberg, Leuven, Belgium
  4. 4Department of Gastroenterology, George Papanikolaou General Regional Hospital, Thessaloniki, Greece
  5. 5Department of Hepatology, Medical Academy of Warsaw, Warsaw, Poland
  6. 6Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, Netherlands
  7. 7Department of Gastroenterology and Hepatology and Department of Epidemiology and Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  8. 8Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  1. Correspondence to:
    Professor H L A Janssen
    Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam ’s Gravendijkwal 230, Room Ca 326, 3015 CE Rotterdam, Netherlands; h.janssen{at}erasmusmc.nl

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Interferon induced HBeAg loss is persistent in up to 90% of patients with chronic hepatitis B (HBV).1–3 Older age and vertical transmission have been shown previously to be independent predictors of relapse after conventional IFN.4 Shorter duration of HBV DNA below 0.7 log10 IU/ml was found to predict relapse after lamivudine.5 Predictors of relapse after PEG-IFN treatment are, however, still unknown. Our aim in this study was to investigate the frequency and predictors of relapse after treatment with PEG-IFN α-2b alone or in combination with lamivudine.

Data for this study were extracted from a multicentre randomised controlled trial comparing 52 weeks of PEG-IFN α-2b monotherapy (100 μg/week) with combined PEG-IFN and lamivudine (100 mg/day) in 266 patients with HBeAg positive chronic hepatitis B. The inclusion and exclusion criteria for the study were reported previously.6 Relapse was defined as HBeAg negativity at the end of treatment (week 52) and recurrence of HBeAg at the end of follow up (week 78).

Treatment groups were comparable regarding baseline characteristics. At the end of treatment, 57 of 130 patients (44%) in the combination therapy group and 40 of 136 (29%) in the monotherapy group lost HBeAg (p = 0.01). HBeAg relapse occurred more often in patients treated with PEG-IFN α-2b and lamivudine combination therapy compared with PEG-IFN α-2b alone (22 of 57 patients (39%) vs five of 40 (13%), p = 0.005). Patients with HBeAg relapse were more likely to have relapse of HBV DNA >200 000 copies/ml than …

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