Study purpose: Most chronic hepatitis B patients undergoing therapy with nucleos(t)ide analogs (NAs) need to continue long-term therapy indefinitely in order to maintain viral suppression the author wanted to determine if a switch from NAs to a finite course of peginterferon alfa-2a (PEGASYS, PEG-IFNa2a) therapy could achieve sustained response. Methods: Non-cirrhotic patients treated with NAs for more than 1 year, with HBV DNA 102 copies/mL during the NA treatment period, were switched to 1 year of PEGIFNa2a (180 ug/week). PEG-IFNa2a was stopped early in case of virological relapse HBV DNA rebound or = 10 exponent 5 copies/mL in HBeAg(+) patients and or = 10 exponent 4 copies/mL in HBeAg(-) patients or in patients who achieved HBsAg seroconversion. Response parameters assessed 1 year after stopping PEG-IFNa2a included HBeAg loss/seroconversion, HBsAg-clearance/seroconversion and virological response [HBV DNA 10 exponent 4 copies/mL HBsAg and HBeAg were quantified using Abbott Architect assays. HB V DNA was determined by real-time PCR (limit of detection or = 10 exponent 2 copies/mL). Results: Overall,13 (56.5 percent) HBeAg(+) and 10 (43.5 percent) HBeAg(-) patients were enrolled. Median duration of NA therapy was 43 months (range 12-132). Of the 23 patients, 13 completed 1 year of PEG-IFNa2a therapy; 3 stopped early following HBsAg clearance during PEG-IFNa2a and 7 stopperj due to virological relapse (and restarted NAs).1 year post-PEG-IFNa2a therapy, 7/23 (30 percent) patients had achieved HBsAg clearance, 4 with HBsAg seroconversion. Of the HBeAg(+) patients, 7/13 (54 percent) had sustained virological response (6 had HBeAg losslseroconversion; 3 cleared HBsAg). The remaining 6HBeAg(+ ) patients had virological relapse; none had HBeAglosslseroconversion. Of the HBeAg(-) patients, 5/10 (50 percent) had sustained virological response (4 cleared HBsAg), the remaining 5 HbeAg(-) had virological relapse without any decrease in HbsAg level. Patients who cleared HBsAg clearance had an on-treatment HBsAg decline 2 log10 IU/mL.
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