Chapter 2.3 74 Taqman PCR. A reliability study with the Cobas Taqman was performed which proved that the two assays are comparable in the dynamic range. 6 In conclusion, a dynamic prediction model adding HBV DNA decline during therapy can provide a more accurate prediction of PEG-IFN induced SR than a prediction model based solely on baseline factors. The models presented here provide valuable information that can be used in individual decision making on treatment (dis)continuation in patients with HBeAg positive chronic hepatitis B during PEG-IFN therapy. Clinicians should consider discontinuing PEG-IFN treatment in patients who have not experienced a 2 log10 decline in HBV DNA levels before week 24.
References Dynamic prediction of response to PEG-IFN 75 1. van Zonneveld M, Honkoop P, Hansen BE, Niesters HG, Murad SD, de Man RA, Schalm SW, Janssen HL. Long-term follow-up of alpha-interferon treatment of patients with chronic hepatitis B. Hepatology 2004;39:804-10. 2. Zoulim F, Perrillo R. Hepatitis B: refl ections on the current approach to antiviral therapy. J Hepatol 2008;48 Suppl 1:S2-19. 3. Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, Tanwandee T, Tao QM, Shue K, Keene ON, Dixon JS, Gray DF, Sabbat J. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med 2004;351:1521-31. 4. Janssen HL, van Zonneveld M, Senturk H, Zeuzem S, Akarca US, Cakaloglu Y, Simon C, So TM, Gerken G, de Man RA, Niesters HG, Zondervan P, Hansen B, Schalm SW. Pegylated interferon alfa-2b alone or in combination with lamivudine for HBeAg-positive chronic hepatitis B: a randomised trial. Lancet 2005;365:123-9. 5. Lau GK, Piratvisuth T, Luo KX, Marcellin P, Thongsawat S, Cooksley G, Gane E, Fried MW, Chow WC, Paik SW, Chang WY, Berg T, Flisiak R, McCloud P, Pluck N. Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B. N Engl J Med 2005;352:2682-95. 6. Buster EH, Flink HJ, Cakaloglu Y, Simon K, Trojan J, Tabak F, So TM, Feinman SV, Mach T, Akarca US, Schutten M, Tielemans W, van Vuuren AJ, Hansen BE, Janssen HL. Sustained HBeAg and HBsAg loss after long-term follow-up of HBeAg-positive patients treated with peginterferon alpha-2b. Gastroenterology 2008;135:459-67. 7. van Nunen AB, Hansen BE, Suh DJ, Lohr HF, Chemello L, Fontaine H, Heathcote J, Song BC, Janssen HL, de Man RA, Schalm SW. Durability of HBeAg seroconversion following antiviral therapy for chronic hepatitis B: relation to type of therapy and pretreatment serum hepatitis B virus DNA and alanine aminotransferase. Gut 2003;52:420-4. 8. van Zonneveld M, Flink HJ, Verhey E, Senturk H, Zeuzem S, Akarca US, Cakaloglu Y, Simon C, So TM, Gerken G, de Man RA, Hansen BE, Schalm SW, Janssen HL. The safety of pegylated interferon alpha-2b in the treatment of chronic hepatitis B: predictive factors for dose reduction and treatment discontinuation. Aliment Pharmacol Ther 2005;21:1163-71. 9. Buster EH, Hansen BE, Lau KE, Piratvisuth T, McCloud PI, Button P, Steyerberg EW, Zeuzem S, Janssen HL. Prediction of response to peginterferon-alha in HBeAg positive chronic hepatitis B: a model based on 721 patients. Gastroenterology 2009;In press. 10. Pas SD, Fries E, De Man RA, Osterhaus AD, Niesters HG. Development of a quantitative real-time detection assay for hepatitis B virus DNA and comparison with two commercial assays. J Clin Microbiol 2000;38:2897-901. 11. Molenberghs G, Verbeke G. Models for discrete longitudinale data. Springer, 2005. 12. Hernan MA, Brumback B, Robins JM. Marginal structural models to estimate the causal effect of zidovudine on the survival of HIV-positive men. Epidemiology 2000;11:561-70.