ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1642961
Adding Pegylated Interferon-α to Nucleos(t)ide Analogues Improves HBsAg Clearance in Chronic Hepatitis B with Low-Level Viremia
Provisionally accepted
- Beijing Youan Hospital, Capital Medical University, Beijing, China
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Introduction: Low-level viremia (LLV) is associated with the progression of liver fibrosis and a high risk of hepatocellular carcinoma in patients with chronic hepatitis B (CHB). The present study aimed to compare the efficacy between nucleos(t)ide analogues (NAs) therapy and combination therapy of NAs and pegylated interferon-α (pegIFN-α) in entecavir (ETV)-treated CHB patients with LLV.This was a retrospective cohort study. ETV-treated CHB patients with LLV were included and divided into the NA group and the NA+IFN group. The NA group comprised patients switching to tenofovir alafenamide fumarate, whereas the NA+IFN group comprised those adding on pegIFN-α additionally. We compared changes in HBV markers and complete virological response (CVR) between the two groups.Results: A total of 127 patients were enrolled, including 51 in NA+IFN group and 76 in NA group. In the NA+IFN group, the decline in HBsAg level from baseline (△HBsAg) was significantly greater (-0.17 log10IU/mL vs. -0.06 log10IU/mL, P = 0.011) at week 24, and HBsAg clearance rate and △HBsAg were significantly higher (8.9% vs. 0%, P = 0.017; -0.27 log10IU/mL vs. -0.11 log10IU/mL, P = 0.023) at week 48. The 48-week CVR rate in the NA+IFN group was 66.7% (34/51), which was comparable to 68.4% (52/76) in the NA group (P = 0.836).In ETV-treated patients with LLV, receiving NAs plus pegIFN-α tends to increase the effect of HBsAg clearance.
Keywords: Low-level viremia, Chronic hepatitis B, Pegylated interferon-α, Tenofovir alafenamide fumarate, HBsAg clearance
Received: 07 Jun 2025; Accepted: 08 Aug 2025.
Copyright: © 2025 Wang, Lu, Liu, Ren, Chen, Hu and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhongjie Hu, Beijing Youan Hospital, Capital Medical University, Beijing, China
Sujun Zheng, Beijing Youan Hospital, Capital Medical University, Beijing, China
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