Effect of antiviral therapy combined with interferon on negative conversion rate of surface antigen among patients of chronic hepatitis B treated with nucleos(t)ide analogues

Objective To investigate the effect of antiviral therapy combined with interferon on negative conversion rate of surface antigen in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues. Methods From January 2014 to January 2018, a total of 75 patients with CHB treated with NAs were selected from Beijing Ditan Hospital, Capital Medical University. All the patients with HBV DNA < 100 IU/ml and HBsAg < 1 000 IU/ml were divided into two groups: NAs continued treatment group (37 cases) and NAs combination with IFN group (38 cases) according to the patient’s willingness to accept the interferon treatment. The patients were treated for 48 weeks. The serum level of HBsAg decreased at 24 weeks, the rate of HBsAg negative at 48 weeks and the related predictors of HBsAg negativity were observed in both groups, respectively. Results In the NAs combination with IFN group (27 cases: among the 38 cases, 1 case was eliminated and 10 cases had not been followed up), the percentage of HBsAg clearance was 48.15% (13/27) and the HBsAg seroconversion rate was 44.44% (12/27), while in NAs continued treatment group (37 cases), both of the two percentages were 5.41% (2/37), with significant differences (χ2 = 13.599, P 0.5 log10IU/ml was 56.76% (21 cases). However, patients in NAs continued treatment group, the average level of quantitative HBsAg was 578.82 (53.29, 778.76) IU/ml, HBsAg decreased by 31.54 (-14.43, 59.29) IU/ml compared with the level at baseline and the percentage of HBsAg decrease > 0.5 log10IU/ml was 8.11% (3 cases), all with significant differences (Z =-3.850, P 0.5 log10IU/ml was correlated with the negative conversion of HBsAg at the 48th week of treatment in patients with CHB who were effectively controlled by HBV DNA and with low level of HBsAg after treatment with NAs. Conclusions After NAs treatment, CHB patients of HBV DNA effectively controlled and low HBsAg level treated by combination of NAs and IFN could promote the decrease of HBsAg level and increase the negative conversion rate of HBsAg. Key words: Hepatitis B; Clinical cure; Combination therapy; HBsAg negative rate