Clinical outcomes after HBsAg clearance in chronic hepatitis B patients treated with Peg-IFN α: A study with an 11- to 173-month follow-up

Wen Deng; Hongxiao Hao; Ziyu Zhang; Xinxin Li; Weihua Cao; Yaqin Zhang; Shiyu Wang; Zixuan Gao; Linmei Yao; Shuojie Wang; Xin Wei; Wei Yi; Linqing Zhao; Yao Xie; Minghui Li

doi:10.1016/j.virs.2025.06.008

August 2025

. doi: 10.1016/j.virs.2025.06.008

Citation: Wen Deng, Hongxiao Hao, Ziyu Zhang, Xinxin Li, Weihua Cao, Yaqin Zhang, Shiyu Wang, Zixuan Gao, Linmei Yao, Shuojie Wang, Xin Wei, Wei Yi, Linqing Zhao, Yao Xie, Minghui Li. Clinical outcomes after HBsAg clearance in chronic hepatitis B patients treated with Peg-IFN α: A study with an 11- to 173-month follow-up .VIROLOGICA SINICA, 2025, 40(4) : 579-586. http://dx.doi.org/10.1016/j.virs.2025.06.008

Peg-IFN α治疗慢性乙型肝炎患者HBsAg清除后的临床结果：一项随访11至173个月的研究

邓雯 ^a,b ,
郝红晓 ^a,b ,
张子昱 ^a,b ,
李鑫鑫 ^a,b ,
曹卫华 ^a,b ,
张亚琴 ^a,b ,
王诗雨 ^a,b ,
高子轩 ^a,b ,
姚林梅 ^a,b ,
王烁杰 ^a,b ,
韦欣 ^a,b ,
易为 ^c,, ,
赵林清 ^d,, ,
谢尧 ^a,b,e,, ,
李明慧 ^a,b,e,,

a 首都医科大学附属北京地坛医院肝病二科;
b 首都医科大学HBV感染、临床治愈与免疫联合实验室;
c 首都医科大学附属北京地坛医院妇产科;
d 首都儿科研究所病毒研究室/北京市儿童病毒病学重点实验室;
e 北京大学地坛医院教学医院肝病二科

通讯作者： 易为, yiwei1215@163.com; 赵林清, linqingz525@163.com; 谢尧, xieyao00120184@sina.com; 李明慧, wuhm2000@sina.com
收稿日期： 2025-01-13
录用日期： 2025-06-21

摘要

本研究旨在探讨慢性乙肝患者经Peg-IFNα治疗获得HBsAg清除后长期肝脏不良事件的风险及影响因素，为此回顾性分析了2008-2023年北京地坛医院456例获得HBsAg清除并停用Peg-IFNα的患者资料。以HBsAg清除及停药时间为基线，终点事件为首次出现肝脏不良事件（肝细胞癌或腹水）或末次随访。评估肝脏不良事件发生率、危险因素及肝纤维化、肝硬化和肝功能指标变化。结果显示，中位随访70个月期间，肝脏不良事件发生率为2.30%（肝细胞癌1.76%，腹水0.55%）。高龄（HR=1.075）和肝硬化（HR=41.393）是显著危险因素（均P<0.01）。随访时APRI评分较基线显著改善（0.25 vs 0.53，P<0.001），肝硬化比例由5.70%降至0.88%（P<0.001）。由此得出结论，获得HBsAg清除并停用Peg-IFNα的患者肝脏不良事件风险较低，高龄和肝硬化仍是主要危险因素。
- 乙型肝炎病毒
- , HBsAg清除
- , 聚乙二醇干扰素α
- , 临床结局
- , 肝细胞癌

Clinical outcomes after HBsAg clearance in chronic hepatitis B patients treated with Peg-IFN α: A study with an 11- to 173-month follow-up

Wen Deng ^a,b ,
Hongxiao Hao ^a,b ,
Ziyu Zhang ^a,b ,
Xinxin Li ^a,b ,
Weihua Cao ^a,b ,
Yaqin Zhang ^a,b ,
Shiyu Wang ^a,b ,
Zixuan Gao ^a,b ,
Linmei Yao ^a,b ,
Shuojie Wang ^a,b ,
Xin Wei ^a,b ,
Wei Yi ^c,, ,
Linqing Zhao ^d,, ,
Yao Xie ^a,b,e,, ,
Minghui Li ^a,b,e,,

a. Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China;
b. HBV Infection, Clinical Cure and Immunology Joint Laboratory, Capital Medical University, Beijing, 100069, China;
c. Department of Gynecology and Obstetrics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China;
d. Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, 100020, China;
e. Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, 100015, China

Corresponding author: Wei Yi, yiwei1215@163.com Linqing Zhao, linqingz525@163.com Yao Xie, xieyao00120184@sina.com Minghui Li, wuhm2000@sina.com
Received Date: 13 January 2025
Accepted Date: 21 June 2025

Abstract

To investigate the risk and influencing factors of long-term liver adverse events in chronic hepatitis B patients achieving hepatitis B surface antigen (HBsAg) clearance after pegylated interferon α (Peg-IFN α) treatment, a retrospective analysis was conducted on 456 patients at Beijing Ditan Hospital from 2008 to 2023 who achieved HBsAg clearance and discontinued Peg-IFN α treatment. The baseline was defined as the time of HBsAg clearance and treatment cessation. The endpoint was the first occurrence of liver adverse events (hepatocellular carcinoma or ascites) or last follow-up. Subsequently, we evaluated the incidence and risk factors of liver adverse events, along with changes in liver fibrosis, cirrhosis, and liver function indicators. During a median follow-up of 70 months, the incidence of liver adverse events was 2.30%, hepatocellular carcinoma 1.76%, and ascites 0.55%. Older age and cirrhosis were significant risk factors (HR 1.075 and 41.393, both P < 0.01). The APRI score significantly improved at follow-up compared to baseline (0.53 vs. 0.25, P < 0.001), and cirrhosis prevalence decreased from 5.70% to 0.88% (P < 0.001). In conclusion, patients who achieved HBsAg clearance and discontinued Peg-IFN α treatment have a low risk of liver adverse events, while advanced age and cirrhosis remain major risk factors.
- Hepatitis B virus (HBV)
- , HBsAg loss
- , Pegylated interferon α
- , Outcome
- , Hepatocellular carcinoma

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