Abstract 230 - IMPIEGO DEI GLICOPEPTIDI NELLA ... - SIMIT

229
10° CONGRESSO NAZIONALE SIMIT
Abstract 190
- VIRAL LOAD REDUCTION AND VIROLOGICAL RESPONSE IN HBEAG-NEGATIVE
CHRONIC HEPATITIS B TREATED WITH PEGINTERFERON ALFA-2A (PEG-IFN?-2A)
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Chessa L.* [2] , Pasetto M. C. [2] , Balestrieri C. [2] , Serra G. [2] , Conti M. [2] , Iovine M. [2] , Cappellini S. [2] , Casu S. [2] ,
Casale M. [2] , Figorilli F. [2] , Onali S. [2] , Lai M. E. [2] , Farci P. [2]
- [2] Department of Medical Sciences - University of Cagliari ~ Cagliari
INFEZIONI DA VIRUS EPATITICI
Premessa: Chronic HBV infection is an important word health problem. PEG-IFN?-2a has
been used to treat HBeAg-negative chronic hepatitis B, although the rate of virological
response is still unsatisfactory. Some studies showed that HBsAg titer and HBV DNA
levels could be useful to predict the response to PEG-IFN?-2a.
Obiettivo: The aim was to evaluate whether the baseline and early kinetics of serum HBV
DNA may identify responders from non-responders to PEG-IFN?-2a.
We analyzed 24 patients (17 males), mean age 51 yrs (SD±10), mean disease duration
14.7 yrs (SD±7.9), 9 patients received IFN? in the past (10-15 years before). 19 patients
underwent to liver biopsy, 9 had fibrosis = F3, and 2 had cirrhosis. Inclusion criteria were:
HBeAg negative chronic hepatitis B, age 18-70 yrs. Exclusion criteria were: steroid or NAs
treatment, coinfection with HIV, HCV or HDV. All patients received PEG-IFN (180
µg/week) for 48 months; the mean follow-up period was 42.2 months (range 24-84).
Patients with normal ALT and HBV DNA < 2000 IU/ml after 24 months of follow-up were
considered responders.
Risultati: Eight patients (33.3%) were responders (R) and 16 non-responders (NR). There
was no difference in baseline characteristics (duration of disease, previous IFN, alcohol
intake, ALT and HBV DNA, histological score at the baseline) between R and NR. R had a
slightly younger age than NR (47 vs 52 yr), and all were males. There was no difference in
ALT levels during the first 12 weeks of therapy between R and NR, while the mean levels
of HBV DNA showed a significant reduction in R compared to NR at week 4 (1.10 log10,
p=0.03) and at week 12 (1.25 log10, p=0.01). Among R, 5 out of 8 lost HBsAg with
clearance during the follow-up.
Conclusione: The only difference between responders and non-responders to PEG-IFN
was a significant reduction in serum HBV DNA at week 4, which persisted at week 12 of
treatment. Importantly, our study shows that clearance of HBsAg was achieved in 62% of
responders during the long-term follow-up