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Background/objective <p>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.</p> Methods <p>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&#xa0;weeks post-treatment.</p> Results <p>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&#xa0;weeks of PEG-IFN α-2a treatment were independent predictors of fibrosis progression. Among these, GPR at 24&#xa0;weeks exhibited the highest predictive value (Corrected AUC = 0.805).</p> Conclusion <p>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&#xa0;weeks of treatment was an independent predictive factor for the progression of liver fibrosis in this population.</p>

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The ratio of GGT to PLT indices is a predictive factor for the progression of liver fibrosis in NA-treated chronic hepatitis B patients with advanced fibrosis plus PEG-IFN α-2a therapy: a case–control study

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  • 发表日期：

    2025年12月10日

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  • Ling Li,
  • Huili Li,
  • Yiru Zhao,
  • Lisha Shi,
  • Mireyi Suwanbai,
  • Liying Ren,
  • Guojun Li,
  • Xiucheng Pan

摘要

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.