A recent analysis has found that certain viral markers can help predict how patients with chronic hepatitis B will respond to pegylated interferon (PEG-IFN) treatment. The research focused on improving the chances of achieving a functional cure, defined as the loss of hepatitis B surface antigen (HBsAg), which remains low with current therapies.
Researchers reviewed 38 studies involving 6,179 patients to evaluate which virological markers are most effective in predicting either a functional cure or the loss of hepatitis B e antigen (HBeAg) after PEG-IFN therapy. The team systematically searched major medical databases up to November 2023 and assessed the predictive value of these markers using summary receiver operating characteristic curves.
The findings showed that a decline in HBsAg at week 24 had the highest ability to discriminate between those who would achieve a functional cure and those who would not, with an area under the curve (AUROC) of 0.89 and sensitivity of 0.88. Baseline HBsAg also performed well, with an AUROC of 0.86 and specificity of 0.79. Both were found to be significantly better predictors than baseline hepatitis B core-related antigen or HBV RNA.
For predicting HBeAg loss or seroconversion, several markers measured at weeks 12 and 24—such as HBV RNA, HBV DNA, HBeAg levels, and their declines—showed similar predictive values (AUROC between 0.75 and 0.78). Among these, HBV RNA and HBeAg levels at week 24 offered optimal sensitivity (0.87), while HBeAg decline at week 12 provided the highest specificity (0.83).
"HBsAg decline at week 24 and baseline HBsAg levels are better predictors of functional cure than novel virologic markers, while on-treatment HBV RNA and HBeAg levels and dynamic changes are the most reliable indicators for HBeAg loss," according to the study authors.
These results suggest that monitoring established viral markers during treatment could improve patient management in chronic hepatitis B by identifying those most likely to benefit from PEG-IFN therapy.
