Abstract
BACKGROUND/OBJECTIVE: Combination therapy with pegylated interferon α-2a (PEG-IFN α-2a) and nucleoside analogue (NA) has been shown to improve liver histology in patients with chronic hepatitis B (CHB) and hepatic fibrosis. PEG-IFN α-2a effectiveness was assessed in NA-treated CHB patients with advanced fibrosis/compensated cirrhosis. METHODS: This retrospective multicenter study included NA-treated CHB patients with advanced fibrosis/compensated cirrhosis. Patients received 48-week PEG-IFN α-2a plus 24-week follow-up. The primary endpoint was liver fibrosis status 24 weeks post-treatment. RESULTS: A total of 102 patients were enrolled in the study, including 35 and 67 baseline HBeAg-positive and HBeAg-negative CHB patients, respectively. At the end of PEG-IFN α-2a treatment, a total of 18 (17.6%) patients achieved HBsAg loss, and 23 (65.7%) achieved HBeAg loss. Sixty-nine patients completed the comparison of liver fibrosis and cirrhosis before and after treatment, of whom 16 (23.2%) experienced progression of liver fibrosis or cirrhosis, 32 (46.4%) experienced liver fibrosis reversal, and 21 (30.4%) remained stable. Penalized logistic regression analysis demonstrated that GPR (Intercept = -1.200; Coefficients = 0.102) and GGT levels (Intercept = -1.198; Coefficients = 0.048) at 24 weeks of PEG-IFN α-2a treatment were independent predictors of fibrosis progression. Among these, GPR at 24 weeks exhibited the highest predictive value (Corrected AUC = 0.805). CONCLUSION: Approximately one-fifth of the NA-treated CHB patients with advanced liver fibrosis and compensated cirrhosis experienced progression of liver fibrosis after PEG-IFN α-2a treatment. The GPR at 24 weeks of treatment was an independent predictive factor for the progression of liver fibrosis in this population.