30-32 Furthermore, this HBV DNA threshold and the duration of follow-up correspond with the definition of response to peginterferon therapy according to the recent European guidelines and the pivotal studies on peginterferon in CHB, respectively.10, 20, 33 The large majority of our patients were of Caucasian
origin and were infected with HBV genotypes A and D. Responsiveness to interferon-based therapy appears to be lower in patients with genotype find protocol D versus patients with other genotypes, and this may explain the limited efficacy of peginterferon in our study population.9, 10, 26, 34 A recent retrospective analysis of 264 HBeAg-negative patients treated with peginterferon alfa-2a alone or in combination with lamivudine
reported that pretreatment HBsAg levels varied according to Selleck RG7422 the genotype. The highest concentrations were found in patients infected with genotypes A and D. Although serum HBsAg levels decreased during the treatment phase for all genotypes, the HBsAg decline was least pronounced in patients with genotype D.35 Therefore, our data on the decline in HBsAg levels need to be confirmed in patients with genotypes B and C. In summary, the current study shows that a combination of early quantitative serum HBsAg and HBV DNA levels allows the best selection of patients with HBeAg-negative CHB who will not respond to a 48-week course of peginterferon alfa-2a therapy. The discontinuation of peginterferon therapy and a switch to an alternative treatment appear to be indicated in patients without a decline in HBsAg levels combined with a
decline in HBV DNA levels of less than 2 log copies/mL at week 12. In addition to the Temsirolimus supplier authors, the study group includes the following members: in Austria, P. Munda, T. M. Scherzer, and K. Staufer (Medical University of Vienna, Vienna) and W. Vogel and I. Graziadei (Innsbruck Medical University, Innsbruck); in Germany, G. Gerken (University Hospital Essen, Essen) and C. Niederau (St. Josef Hospital Oberhausen, Oberhausen); in Greece, G. Germanidis (Papageorgiou General Hospital, Thessaloniki), G. Hatzis (Laikon General Hospital, Athens), G. Kitis and P. Xiarchos (George Papanikolaou Hospital, Thessaloniki), M. Raptopoulou-Gigi, E. Gigi, and E. Sinakos (Aristotle University of Thessaloniki, Thessaloniki), and I. Vafiadis-Zouboulis, P. Nicolaou, and G. Paraskevi (University of Athens Medical School, Athens); in Italy, P. Grima (S. Caterina Novella Hospital, Galatina), G. Montalto (Universita di Palermo, Palermo), M. Russello (Azienda Ospedaliera Garibaldi–Nesima, Catania), G. Scifo (Presidio Ospedaliero Muscatello, Augusta), A. Spadaro (University Hospital Messina, Messina), and S. Tripi (Universita di Palermo, Palermo); in the Netherlands, M. F. C. Beersma, M. L. op den Brouw, S. D. Diepstraten, G. J. van Doornum, C. van der Ent, A. Heijens, A.