i am sure guidelines have not been changed despite we have evidence since 2011 and patients with hbvdna und are not treated by pegintf
http://www1.easl.eu/easl2011/program/Posters/Abstract634.htm
HIGH RATES OF HBSAG SEROCONVERSION AFTER TREATMENT WITH INTERFERON ALFA IN CHRONIC HEPATITIS B VIRUS-INFECTED PATIENTS WITH UNDETECTABLE HBV DNA
H.B. Yu1*, Z.H. Cao1, Y.H. Zhang1, L.N. Ma1, B. Ma1, Y.L. Liu1, Y. Jin1, X.D. Zhang1, H. Wu2, X.Y. Chen1
1International Medical Department, 2Department of Infectious Diseases, Beijing You'an Hospital,Capital University of Medical, Beijing, China. ****@****
Background and aims: The patients infected by hepatitis B virus with undetectable HBV DNA, HBeAg negative/anti-HBe positive are not recommended to receive antiviral therapy currently. However, HBsAg seroconversion is considered the closest outcome to clinical cure and associated with the good long-term prognosis in chronic hepatitis B (CHB). The immune characteristics of B cells and their clinical implication during this treatment in those patients remain unclear. The aim of this study is to investigate the efficacy of antiviral therapy and immune characteristics of B cells in those patients .
Methods: Patients with undetectable HBV DNA, HBeAg negative/anti-HBe positive and HBsAg positive were enrolled, and treated with interferon (peginterferon alfa-2a 135µg/week (n=53) or 180µg/week (n=14) or peginterferon alfa-2b 100µg/week (n=16)). When HBsAg titer300 IU/L) was set to the terminal of the therapy .Flow cytometric was performed to analyze the peripheral total B cell percentages in 3 patients who achieved HBsAg seroconversion and 2 HBsAg-vaccinated healthy controls.
Results: Of the 83 patients received interferon treatment, 26 (31.3%) achieved HBsAg clearance(n=1) and seroconversion(n=25). HBsAg seroconversion occurred after a median of 30 weeks after the treatment (range: 12-132 weeks). Eight patients had completed treatment and were followed for a median of 30 weeks post-treatment (range: 24-60 weeks). All of them sustained HBsAg seroconversion (mean anti-HBs 473.1±298.7 IU/L) during the post-treatment following up. 18 patients are still undergoing treatment (mean anti-HBs 411.2±461.7 IU/L ). The data (3 patients achieving HBsAg seroconversion and 2 HBsAg-vaccinated healthy individuals) indicated that circulating B cell percentages were close to healthy controls at baseline(range:5-7%)and were increased after the HBsAg clearance(range:16-19%).
Conclusions: Patients whose HBV DNA are undetectable in plasma, HBeAg negative/anti-HBe positive and HBsAg positive should be treated, because they can achieve high rates of HBsAg seroconversion. B cells may play an important role in HBsAg clearance /seroconversion.
Financial support: National S&T Major Project for infectious diseases Control (2008ZX10002-013;2008ZX10002-004);863 project (2006AA02A410)