721 THE VALUE OF INTRAHEPATIC HBV TDNA AND CCCDNA AT CESSATION NAS AS AN INDICATOR FOR RELAPSE IN THE CHB PATIENTS

Background: To compare the effects of prolonged and routine pegylated interferon alfa-2a (PEG IFN a-2a) therapy to patients of HBeAg-positive chronic hepatitis B (CHB). Methods: Patients diagnosed as HBeAg-positive CHB having received PEG IFNa-2a (180mg, once weekly) 48 week (routine therapy) or 72 weeks (prolonged therapy) were under this study, from Sep 2006 to Oct 2009 in our unit, consecutively. The sera of these patients were collected every 3 months and viral and biochemical test had been done. In this study, the relapse means HBVDNA were tested above 10 copies/ml or HBeAg became positive again at the end of the 24-week follow-up. Chi-square, t test and Logistic regression were employed to analyze the data. Results: Totally 86 patients were collected into this study, 53 patients achieved 48-week duration routine therapy (Group R) and 33 patients underwent 72-week prolonged duration (Group P). There were no significant difference between the 2 groups in demographic data, gender (P = 0.111), age (P = 0.194), ALT level (P = 0.482), HBVDNA load (lg copies/mL) (P = 0.672) and semiquantitative level of HBeAg (s/co) (P = 0.761). At the end of followup, there were significant difference between the group R and group P at HBVDNA negative (62.3% vs 97.0, P = 0.000), HBeAg seroconversion (39.6% vs 57.6, P = 0.009), HBsAg loss (15.1% vs 36.4, P = 0.023) and relapse (58.5% vs 33.3%, P = 0.010). According to the Logistic regression analysis results, the HBeAg loss related to therapy duration (OR 3.702, 95%CI 1.225–11.188) and gender (male) (OR 3.005, 95%CI 1.038–8.696), didn’t relate to HBeAg level (OR 0.999, 95%CI 0.998–1.000) at baseline and age (OR 0.902, 95%CI 0.839–0.970). Conclusions: In this single center cohort study on PEG-IFN therapy to patients with HBeAg-positive CHB, the effects of prolonged duration therapy were much better than 48-week therapy. Prolonged duration therapy achieved a higher HBsAg lost ratio, HBeAg seroconversion ratio, HBVDNA negative ratio and a lower relapse ratio. Our study implied that treatment duration would play an important role in the course.