Frontiers in cellular and infection microbiology · 2026
HBsAg loss in chronic hepatitis B patients with an HBsAg decline plateau can be enhanced by intermittent PEG-IFN treatment.
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Cao Weihua, Xie Si, Hao Hongxiao, Deng Wen, Zhang Lu, Lu Yao, Liu Ruyu, Wang Shiyu, Li Xinxin, Zhang Ziyu, Wei Xin, Gao Zixuan, Yao Linmei, Wang Shuojie, Gao Yuanjiao, Wang Yujie, Xu Mengjiao, Hu Leiping, Xie Yao, Li Minghui
Аннотация
BACKGROUND: During interferon (IFN) treatment patients with chronic hepatitis B (CHB), HBsAg levels often declines to a plateau. This study investigated the HBsAg loss rate in patients receiving continuous IFN treatment after reaching a plateau compared with patients who suspended IFN treatment for 3-6 months.
METHODS: Patients were enrolled from an observational cohort of CHB patients receiving PEG-IFN-α-based therapy. All patients reached a plateau in qHBsAg decline after 24 weeks of PEG-IFN-α treatment. Patients in the continuous-treatment group received continuous PEG-IFN therapy, while patients in the intermittent-treatment group discontinued initial PEG-IFN therapy for 3-6 months before resuming treatment.
RESULTS: In this retrospective study, 403 CHB patients with a plateau in HBsAg decline after 24 weeks of pegylated IFN-α (PEG-IFN-α) treatment were included. After reaching the plateau, patients either continued PEG-IFN treatment or restarted treatment after an interval. The HBsAg loss rate in the intermittent-treatment group was significantly higher than that in the continuous-treatment group (p = 0.001); in the 278-case propensity score matching (PSM) population, HBsAg loss rates were 21.58% and 8.63%, respectively (p = 0.002). Multivariate Cox regression analysis showed that intermittent therapy (p = 0.017) and HBsAg level at the second plateau time point (p < 0.001) were independent factors of HBsAg loss. Multivariate Cox regression analysis of the PSM-matched population showed that baseline HBsAg level (p = 0.043), HBsAg level at the second plateau time point (p = 0.000), and intermittent therapy (p = 0.004) were independent factors of HBsAg loss.
CONCLUSIONS: Among CHB patients receiving PEG-IFN-based treatment, intermittent treatment was more beneficial than continuous treatment in achieving HBsAg loss once HBsAg decline reached a plateau.
METHODS: Patients were enrolled from an observational cohort of CHB patients receiving PEG-IFN-α-based therapy. All patients reached a plateau in qHBsAg decline after 24 weeks of PEG-IFN-α treatment. Patients in the continuous-treatment group received continuous PEG-IFN therapy, while patients in the intermittent-treatment group discontinued initial PEG-IFN therapy for 3-6 months before resuming treatment.
RESULTS: In this retrospective study, 403 CHB patients with a plateau in HBsAg decline after 24 weeks of pegylated IFN-α (PEG-IFN-α) treatment were included. After reaching the plateau, patients either continued PEG-IFN treatment or restarted treatment after an interval. The HBsAg loss rate in the intermittent-treatment group was significantly higher than that in the continuous-treatment group (p = 0.001); in the 278-case propensity score matching (PSM) population, HBsAg loss rates were 21.58% and 8.63%, respectively (p = 0.002). Multivariate Cox regression analysis showed that intermittent therapy (p = 0.017) and HBsAg level at the second plateau time point (p < 0.001) were independent factors of HBsAg loss. Multivariate Cox regression analysis of the PSM-matched population showed that baseline HBsAg level (p = 0.043), HBsAg level at the second plateau time point (p = 0.000), and intermittent therapy (p = 0.004) were independent factors of HBsAg loss.
CONCLUSIONS: Among CHB patients receiving PEG-IFN-based treatment, intermittent treatment was more beneficial than continuous treatment in achieving HBsAg loss once HBsAg decline reached a plateau.