Peginterferon is preferable to entecavir for prevention of unfavourable events in patients with HBeAg‐positive chronic hepatitis B: A five‐year observational cohort study. (29th October 2017)

• Record Type: Journal Article
• Authors: Li, S.‐Y.; Li, H.; Xiong, Y.‐L.; Liu, F.; Peng, M.‐L.; Zhang, D.‐Z.; Ren, H.; Hu, P.
• Is Part Of: Journal of viral hepatitis. Volume 24 (2017)Supplement 1
• Page Start: 12
• Page End: 20
• Publication Date: 2017-10-29
• Subjects: cohort analysis -- entecavir -- pegylated interferon‐α -- REACH‐B model -- unfavourable events; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.12755
• Languages: English
• ISSNs: 1352-0504

Abstract

Summary: At present, the long‐term effects of pegylated interferon‐α (PEG‐IFN‐α) and entecavir (ETV) are controversial. Studies directly compared the long‐term outcomes of these two drugs have not been completed. This study was designed to compare the clinical outcomes of PEG‐IFN‐α vs ETV therapy in Chinese patients with chronic HBV infection. From September 2008 to December 2016, a large, observational, open‐label, prospective cohort study of HBeAg‐positive patients with CHB who received PEG‐IFN‐α or ETV therapy was carried out at the Second Affiliated Hospital of Chongqing Medical University. Cumulative incidences of unfavourable events were calculated with respect to treatment type. Based on the REACH‐B model, we compared the observed incidence of hepatocellular carcinoma (HCC) with the expected incidence in each group. PEG‐IFN‐α‐treated patients showed a lower cumulative incidences of unfavourable events and cirrhosis than those treated with ETV ( P = .031; P = .044, respectively). Impact factor exploration indicated that treatment type and platelet count are significantly associated with the occurrence of unfavourable events. Based on the REACH‐B model, a lower observed cumulative incidence of HCC was observed in PEG‐IFN‐α‐treated patients than predicted ( P = .038). However, there was no significant difference of the cumulative HCC incidence between the observed and the predicted cases for ETV‐experienced patients ( P = .36). Treatment with PEG‐INF‐α leads to a lower incidence of unfavourable events including cirrhosis and HCC than ETV in patients with HBV. Treatment type and baseline platelet count may be two important factors associated with the long‐term clinical outcomes of patients with CHB.