studies

1198A AASLD ABSTRACTS HEPATOLOGY, October, 2015
However, none of these on treatment HBV DNA elevation was
accompanied by elevated level of alanine aminotransferase
(ALT). The level of baseline ALT showed association with HBeAg
seroconversion (p=0.075). PI alfa-2a was well-tolerated. Conclusions:
This interim analysis showed that, for patients who
achieve virological suppression with oral NA, switching to a
24 weeks PI alfa-2a treatment significantly decrease HBsAg
titer and increases rates of HBeAg seroconversion.
Disclosures:
Jeong Heo - Advisory Committees or Review Panels: Abbvie; Grant/Research
Support: Roche
Won Young Tak - Advisory Committees or Review Panels: Gilead Korea; Grant/
Research Support: SAMIL Pharma; Speaking and Teaching: Bayer Korea
Ki Tae Yoon - Grant/Research Support: Handok; Speaking and Teaching: Gilead,
BMS, MSD, Roche, GSK
The following authors have nothing to disclose: Hyun Young Woo, Soo Young
Park, Won Lim, Youngmi Hong, Young Oh Kweon, Mong Cho
2029
Reduction of HBsAg by peg-interferon given sequentially
after long term nucleot(s)ide analogue therapy:
nationwide multicenter study by Japanese Red Cross
Liver Study Group.
Masayuki Kurosaki, Namiki Izumi; Department of Gastroenterology
and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Background and Aims: The ideal endpoint of antiviral therapy
for chronic hepatitis B is loss of HBs antigen (HBsAg). However
HBsAg loss is rarely achieved by nucleot(s)ide analogues
(NUC). The aim of the present study is to elucidate the degree
of HBsAg reduction and incidence of HBsAg loss by peg-interferon
when given sequentially after long term NUC therapy.
Methods: A total of 54 patients were sequentially treated by 48
weeks of peg-interferon alpha-2a (180 microgram weekly) after
long-term NUC therapy with an overlap of 4 weeks (sequential
therapy group). Preceding NUC therapy was entecavir in 85%
and lamivudine plus adefovir in 15% of patients. The average
duration of preceding NUC therapy was 4.1 years. At the
start of peg-interferon, HBV DNA was undetectable in 93%,
and HBeAg was negative in 69% of patients. For comparison,
68 patients treated by 48 weeks of peg-interferon alpha-2a
(180 microgram weekly) without preceding NUC therapy
was studied (monotherapy group). Serial changes in the titer
of HBsAg were measured by quantitative assay. Results: In
sequential therapy group, HBV DNA remained undetected in
80% of patients after start of peg-interferon and withdrawal of
NUC. In HBeAg positive patients, HBeAg became negative at
the end of therapy in 50% in sequential therapy and 14% in
monotherapy (p=0.04). At the start of peg-interferon, titer of
HBsAg was 850 (1.9-36500) IU/mL in sequential therapy and
1990 (6.0-80360) IU/mL in monotherapy which declined to
166 (1.0 Log IU/mL was 34% vs. 19%, HBsAg reduction
>2.0 Log IU/mL was 16% vs. 7%, and HBsAg loss was 6%
vs. 0% for sequential and monotherapy, respectively. Within
the same individual, average HBsAg reduction during sequential
peg-interferon was significantly higher compared to those
during preceding NUC therapy (0.64 vs. 0.16 Log/year,
p=0.015). Among patients with HBsAg 60 IU/L and decrease in HBsAg level
1.0 Log IU/mL during PEG-IFN alfa-2a therapy. An 8- to 9-year
follow-up of the clinical course showed that the HBsAg levels
decreased at 1.1 Log/mL per year (3.5 Log IU/mL at NA therapy
initiation Ç 2.4 Log IU/mL at the end of the follow-up) in
the 33 patients who had received continuous NA therapy and
at 3.1 Log/mL per year (3.5 Log IU/mL at NA therapy initiation
Ç 2.5 Log IU/mL at PEG-IFN alfa-2a therapy initiation Ç
1.7 Log IU/mL at the end of the follow-up period) in those who
underwent sequential therapy, showing a significant decrease
(p < 0.0001). [Conclusions] Compared with patients who had
undergone continuous NA therapy to decrease HBsAg levels,
those who had received sequential therapy with Peg-IFNα
-2a after a long-term NA had lower HBsAg levels, suggesting
sequential therapy may accelerate the timing of HBsAg loss.
Disclosures:
The following authors have nothing to disclose: Miwa Kawanaka, Ken Nishino,
Jun Nakamura, Tomohiro Tanikawa, Takahito Oka, Noriyo Urata, Mitsuhiko
Suehiro, Hirofumi Kawamoto, Gotaro Yamada