Chronic Hepatitis B Clinical Trial
Official title:
HBsAg Loss/Seroconversion in Inactive Chronic Hepatitis B Carriers Treated With Peginterferon Alpha-2a
Hepatitis B surface antigen loss/seroconversion, considered to be the ideal outcome of
chronic hepatitis B virus (HBV) infection, occurs spontaneously at a low rate in inactive
carriers.
The researchers aim to investigate the ability of peginterferon alpha-2a to achieve surface
antigen loss/seroconversion therapy in inactive carriers with persistently normal alanine
aminotransferase (ALT) levels, undetectable HBV DNA and low surface antigen levels, who
would not generally be considered candidates for therapy.
Chronic HBV inactive carriers were enrolled in the out-patient department of Beijing Ditan
Hospital. All of them were HBsAg positive and anti-HBs negative for more than 6 months with
persistent undetectable HBV DNA and normal ALT levels measured at 3-6 monthly intervals
during the preceding 2 years as well as with serum HBsAg levels ≤100 IU/mL determined on two
occasions during the month prior to treatment. All patients did not have other liver
diseases and contraindications for interferon therapy.
After giving informed consent, patients were treated with weekly subcutaneous injections of
peginterferon alpha-2a 180 µg. The use of other immune suppressive or regulatory drugs and
other antiviral drugs was prohibited during the course of the study.
In this study, the only parameter to assessing the treatment response was HBsAg level
change. Treatment endpoint was HBsAg loss(<0.05 IU/mL) and anti-HBs positive(>10 mIU/mL)
defined as seroconversion.
Depending on the decline of HBsAg level, treatment was either continued for a prolonged
period until the endpoint was achieved, or terminated in case of nonresponse. Treatment was
proceeded if HBsAg level continued to decline until HBsAg seroconversion was achieved and
the anti-HBs level was above 200 mIU/ml. If the patients were not willing to extend
treatment, the therapy was ended at the time of HBsAg loss, or stopped without further
decline of HBsAg levels on three months treatment.
Liver function parameters, including ALT, aspartate aminotransferase (AST), albumin (ALB)
and total bilirubin (Tbil) were examined using an automated biochemical analyzer. Peripheral
blood neutrophil and platelet count were detected before treatment, and monitored during
treatment with one to three month intervals, and base on the test results to adjust the next
checking time. Quantitative HBV DNA testing was conducted using a commercially available
real-time fluorescence quantitative PCR kit. HBsAg levels were quantified with Architect
i2000 HBsAg quantitative assay (Abbott Laboratories) kit.
The main efficacy endpoints were HBsAg loss and seroconversion.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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