Efficacy of interferon for chronic hepatitis B in patients with nucleoside and nucleotide combination therapy failure
Abstract
Background and Aim
In China, inappropriate therapies with nucleos(t)ide analogues (NA) have induced hepatitis B virus resistance, combination therapy with nucleoside and nucleotide (ComTNsNt) failure, or multi-drug resistant mutations. However, the efficacy of combination therapy with entecavir plus tenofovir for ComTNsNt failure is limited. In the current study, the regimens of interferon-α (IFN-α) therapy, switching from NAs to IFN-α, and subsequent re-treatment with IFN-α were applied to treat ComTNsNt failure. We further evaluated the efficacy of this therapy.
Methods
Eleven patients with ComTNsNt failure were enrolled in this study. Nine subjects (9/11) received IFN-α switching therapy. Combination therapy with IFN-α and ComTNsNt was administered in the first 4 weeks. Then, ComTNsNt was discontinued at the end of Week 4, and IFN-α monotherapy was continued for 6 months. Two (2/11) patients discontinued ComTNsNt without receiving IFN-α treatment. All 11 patients received the first re-treatment of IFN-α when they experienced hepatitis relapses after the withdrawal of IFN-α or ComTNsNt. Six (6/11) patients received a second re-treatment of IFN-α. Follow up was conducted after IFN-α therapy in all 11 patients.
Results
Two patients (2/9) receiving IFN-α switching therapy experienced alanine aminotransferase (ALT) flare. In contrast, the two patients without IFN-α switching therapy experienced ALT flare. Multiple re-treatments with IFN-α resulted in a sustained response.
Conclusions
Interferon-α switching therapy and IFN-α re-treatment might be applied for treatment of ComTNsNt failure. IFN-α switching therapy resulted in safe ComTNsNt cessation, and IFN-α re-treatment induced a sustained response of IFN-α in all patients. This IFN-α treatment is an optional treatment for ComTNsNt failure.
