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View PDF Version - RePub - Erasmus Universiteit Rotterdam

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Factors that predict response to PEG-IFN 53<br />

used to calculate the predicted probability of response in individual patients. A rapid<br />

estimate can be obtained from the provided fl owcharts.<br />

We recommend to start PEG-IFN therapy in patients with the highest chance of achieving<br />

sustained response (table 2). We arbitrarily chose those with a predicted probability<br />

of sustained response of at least 30% to be good candidates for PEG-IFN therapy. About<br />

25% of patients included in this study had a predicted probability of sustained response<br />

above this level. This includes all HBV genotype A infected patients except for those<br />

with low ALT and high HBV DNA levels. In addition, genotype C infected patients with<br />

high ALT and low HBV DNA levels have a high likelihood of response to PEG-IFN. All<br />

remaining patients are moderate candidates for PEG-IFN except for those with genotype<br />

D, who have a rather low chance of achieving sustained response and are in our<br />

view generally not candidates for treatment with PEG-IFN.<br />

Table 2. Recommendations for the use of peginterferon (PEG-IFN) as initial antiviral therapy.<br />

HBV genotype General recommendations for HBeAg positive chronic hepatitis B patients<br />

A Either high ALT (≥2 x ULN) or low HBV DNA levels (

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