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Public Library of Science, PLoS ONE, 6(6), p. e20752, 2011

DOI: 10.1371/journal.pone.0020752

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Long-Term Effect of Interferon Plus Ribavirin on Hepatitis B Surface Antigen Seroclearance in Patients Dually Infected with Hepatitis B and C Viruses

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Background: Interferon-alpha/ribavirin combination therapy might promote hepatitis B surface antigen HBsAg seroclearance in patients dually infected with hepatitis B and C viruses HBV/HCV, but the long-term effect remains unclear. We aimed to investigate the rate of and the factors associated with HBsAg seroclearance during long-term follow -up after interferon-alpha/ribavirin combination therapy in HBV/HCV dually-infected patients. Methodology/Principal Findings: Eighty-one patients who received interferon-alpha/ ribavirin combination therapy for 24 weeks with a follow-up period of >24 weeks were enrolled. HBV serological markers and HBV DNA were determined every 6 months. Early and late HBsAg seroclearance were defined as HBsAg loss in less or more than 6 months after end-of- treatment, respectively. Fifteen 18.5% patients had HBsAg seroclearance during a mean follow-up period of 3.4 0.5-5.1 years. The 5-year cumulative incidence was 25.6%. Baseline cirrhosis and HBV DNA negativity 1 year after end-of-treatment were independently predictive of HBsAg seroclearance with an odds ratio OR, 95% confidence intervals CI of 16.6, 1.8-153 and 9.2, 1.4-62.1, respectively, by Cox regression hazard analysis . Four patients developed early and 11 developed late HBsAg seroclearance, respectively. Cox regression hazard analysis showed no factor was associated with early HBsAg seroclearance, whilst HBV DNA negativity 1 year after end-of-treatment was the only significant factor predicting late HBsAg loss OR, 43.0; CI, 2.5-745. Five patients had HBsAg seroconversion with a 5-year cumulative incidence of 8 .3%. HBV DNA negativity at baseline and one year after EOT had a trend for HBsAg seroconversion. HCV response did not correlate to HBsAg loss. Conclusions: We demonstrated that interferon-alpha/ribavirin had long-term effect on HBsAg seroclearance in dually HBV/HCV-infected patients. Baseline cirrhosis and seroclearance of HBV DNA 1 year after end-of- treatment were significant factors associated with HBsAg seroclearance.