Infectious diseases now · 2026
The impact of pretreatment HBs-Ag levels on response to interferon therapy in chronic hepatitis D patients.
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Kiliç Salih, Taha Ahmed, Yalniz Mehmet, Halil Bahçecioğlu İbrahim
Аннотация
BACKGROUND: Hepatitis D virus (HDV) infection is closely associated with hepatitis B virus (HBV) infection. Given the virological dependence of HDV on HBV for its replication, quantitative HBsAg levels have been considered as potential predictors of treatment outcomes. This study aims to investigate the actual role of pretreatment HBsAg levels as predictors of treatment response to Peg-IFNα therapy in chronic hepatitis D patients.
METHODS: A retrospective analysis was conducted on 42 patients with chronic hepatitis D who had received a 48-week course of Peg-IFNα therapy (180 μg weekly). All of these patients were positive for HBsAg, anti-HDV, and HDV-RNA. Sustained virological response (SVR) was defined as undetectable HDV-RNA (<100 copies/mL) at 24 weeks subsequent to treatment completion (week 72). End-of-treatment (EOT) response was defined as undetectable HDV-RNA at week 48. Baseline quantitative HBsAg levels were measured using the Architect HBsAg assay. Statistical analyses included t-tests, Mann-Whitney U tests, Chi-square tests, and ROC analysis.
RESULTS: Out of the 42 patients, 25 (59.5%) had available SVR data at week 72. Fourteen of them (56.0%) achieved SVR and 11 (44.0%) were non-responders. The mean baseline HBsAg level was 2972 IU/mL (±1208.8 SD). The t-test showed no significant difference in mean HBsAg levels between SVR responders (2789.4 IU/mL ±1421.8 SD) and non-responders (3185.2 IU/mL ±801.5 SD; p = 0.412). ROC analysis for SVR yielded an AUC of 0.589 (95% CI: 0.381-0.797). For EOT response, the AUC was 0.606 (95% CI: 0.421-0.791). Even though exploratory quartile analysis for EOT response revealed a significant association (p = 0.008), given the multiplicity of comparisons, this finding should be interpreted with caution.
CONCLUSION: Baseline HBsAg levels do not predict SVR at 24 weeks post-treatment. The predictive value for EOT response is limited (AUC 0.606). Quantitative HBsAg testing alone is unlikely to provide sufficient predictive accuracy for clinical decision-making in CHD. Sustained HBsAg decline during treatment may provide a perusasive rationale for personalized treatment duration.
METHODS: A retrospective analysis was conducted on 42 patients with chronic hepatitis D who had received a 48-week course of Peg-IFNα therapy (180 μg weekly). All of these patients were positive for HBsAg, anti-HDV, and HDV-RNA. Sustained virological response (SVR) was defined as undetectable HDV-RNA (<100 copies/mL) at 24 weeks subsequent to treatment completion (week 72). End-of-treatment (EOT) response was defined as undetectable HDV-RNA at week 48. Baseline quantitative HBsAg levels were measured using the Architect HBsAg assay. Statistical analyses included t-tests, Mann-Whitney U tests, Chi-square tests, and ROC analysis.
RESULTS: Out of the 42 patients, 25 (59.5%) had available SVR data at week 72. Fourteen of them (56.0%) achieved SVR and 11 (44.0%) were non-responders. The mean baseline HBsAg level was 2972 IU/mL (±1208.8 SD). The t-test showed no significant difference in mean HBsAg levels between SVR responders (2789.4 IU/mL ±1421.8 SD) and non-responders (3185.2 IU/mL ±801.5 SD; p = 0.412). ROC analysis for SVR yielded an AUC of 0.589 (95% CI: 0.381-0.797). For EOT response, the AUC was 0.606 (95% CI: 0.421-0.791). Even though exploratory quartile analysis for EOT response revealed a significant association (p = 0.008), given the multiplicity of comparisons, this finding should be interpreted with caution.
CONCLUSION: Baseline HBsAg levels do not predict SVR at 24 weeks post-treatment. The predictive value for EOT response is limited (AUC 0.606). Quantitative HBsAg testing alone is unlikely to provide sufficient predictive accuracy for clinical decision-making in CHD. Sustained HBsAg decline during treatment may provide a perusasive rationale for personalized treatment duration.