ABSTRACT
Objective To investigate the predictive value of on-treatment hepatitis B surface antigens (HBsAg)levels for HBsAg loss/seroconversion in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB)patients treated with pegylated interferon (peg-IFN)-α-2a.Methods HBeAg-negative CHB naive patients were collected from 2008 May to 2011 August in Beijing Ditan Hospital affiliated to Capital Medical University.Eligible patients had been HBsAg-positive,HBeAg-negative and with detectable hepatitis B virus (HBV)DNA for>6 months,had elevated alanine aminotransferase for>3 months,had no other liver diseases,and had been treated with peg-IFN-α-2a>3 months or had finished the treatment.All the enrolled patients were administered with peg-IFN-α-2a 180 μg/week.Serum HBV DNA,HBsAg,and anti-HBs levels were measured at baseline and every 3 months during peg-IFN-α-2a treatment.The primary efficacy of response to the treatment was HBsAg loss.Comparison between groups was conducted by chi-square test.The absolute levels of HBsAg and the decline rate of HBsAg at week 12 and week 24 were assessed using receiver operating characteristic (ROC)curve for predicting HBsAg loss at week 96 and week 120.Results A total of 81 patients were included into the data analysis. According to on-treatment HBsAg decline,patients were divided into completed response group (12 cases, 14.8%),partial response group (20 cases,24.7%),and poor response group (49 cases,60.5 %).On week 12 of treatment,mean HBsAg decline levels in completed response and partial response groups were 0.62(0.06,0.91)lg IU/mL and 0.19 (-0.01 ,0.48)lg IU/mL,respectively,which was not statistical different (Z =1 .581 ,P =0.209 ).Adjusting for differences of baseline factors (calculation of the mean decline of HBsAg),completed response group and partial response group had much more pronounced decline than poor response group 0.00 (-0.01 ,0.14)lg IU/mL,χ2 =9.00,P <0.01 ].On week 24, difference of HBsAg decline among the 3 groups was statistically significant (χ2 =27.72,P <0.01).The predictive ability of HBsAg cut-off level at week 24 was better than week 12 for HBsAg loss at either 96 or 120 weeks,and the differences of the area under the ROC curve were both significantly different (χ2 =3.880,P =0.049 and χ2 =4.412,P =0.036,respectively).Conclusion Dynamics of HBsAg level in early treatment of peg-IFN-α-2a can predict the therapeutic effect of patients with HBeAg-negative CHB.
ABSTRACT
Objective To investigate the effect of Peg-Interferon α-2a therapy on the quality of life (QOL) of patients with chronic hepatitis C,and to evaluate the effect of healthcare insurance policy in Guangzhou city on these patients.Methods Totally 102 patients with chronic hepatitis C were enrolled.Forty-two patients (group A) were treated with Peg-Interferon α-2a plus ribavirin whose medical expenses were covered by medical insurance; 30 patients (group B ) received the same therapy but at their own expenses ; and the other 30 patients ( group C) were not treated with Peg-Interferon α-2a.QOL of patients in three groups were investigated using the general quality of life inventory questionnaire (GQOLI-74) before and after Peg-Interferon α-2a treatment.Wilcoxon test was used to compare on all scales and total scores before and after treatment in each group,and Kruskal-Wallis test was performed to compare on all scales and total scores among three groups.Results Before treatment,the physical function,psychological function,social function,material life and total score of group A were 55.3,58.8,61.9,60.6 and 58.5 ; those of group B were 57.5,60.4,61.1,55.2 and 58.3; those of group C were 58.6,60.3,57.5,54.8 and 56.4.There was no statistic difference on all scales and total scores among three groups (Z =- 1.177,- 0.846,- 1.062,-0.377 and - 1.085,P ＞ 0.05).After treatment,group A had higher QOL on all scales (67.1,76.4,68.1,70.1) and total score (72.6) than group C (54.6,54.0,53.3,57.5 and 54.6,P ＜0.01) ; group B had higher QOL (P ＜0.05) on three scales (65.1,65.0 and 69.6) and total score ( 64.3 ) except material life ( 56.3 ) than group C ; group A had higher QOL on psychological function,material life and total score than group B ( P ＜ 0.05 ).Conclusions QOLs of chronic hepatitis C patients treated with Peg-Interferon α-2a are higher than those without Peg-Interferon α-2a treatment.Patients whose medical expenses are covered by medical insurance may have higher QOLs than those at their own expenses.