Clinical Characteristics and Factors Associated with Hair Loss Severity in Chronic Hepatitis B Patients Receiving Pegylated Interferon-Alpha: A Retrospective Cohort Study.

OBJECTIVE

To characterize the phenotype and evaluate factors associated with hair loss severity in patients already experiencing alopecia during pegylated interferon alpha therapy or nucleos(t)ide analog therapy for CHB.

METHODS

This retrospective cohort study included 78 CHB patients presenting with hair loss. Thirty-eight patients received Peg-IFNα combined with nucleos(t)ide analogs, and 40 received nucleos(t)ide analogs alone. Clinical and trichoscopic characteristics were assessed, and hair loss severity was categorized by daily hair shedding (<50, 50-100, >100 hairs/day). Multivariate ordered logistic regression examined the independent association between interferon therapy and hair loss severity, adjusting for age, sex, duration of alopecia, family history, and other contributing factors.

RESULTS

Telogen effluvium was significantly more frequent in the interferon group than in the nucleos(t)ide analog group (73.7% vs 25.0%, P<0.001), accompanied by shorter disease duration (median 2.0 vs 24.0 months, P<0.001), and more severe daily shedding (>100 hairs/day: 26.3% vs 10.0%, P=0.014). Interferon therapy independently increased hair loss severity (OR=3.21, 95% CI: 1.00-10.28, P=0.049). Increasing age (OR=0.89, P=0.005) and male sex (OR=0.29, P=0.018) were protective.

CONCLUSION

Among CHB patients presenting with alopecia, Peg-IFNα therapy is independently associated with greater hair loss severity, predominantly presenting as acute telogen effluvium. This underscores the need for proactive counseling and monitoring, particularly among younger female patients.