Even 69% of those who did not respond at the end of treatment subsequently demonstrated HBeAg seroconversion. Overall, HBeAg seroconversion at five years after the end of treatment was seen in an impressive 60% of the total sample.[13] Recommendation Clinical studies in Japan have found that 17% – GSK2126458 in vitro 20% of patients with HBeAg positive chronic hepatitis B administered Peg-IFNα-2a at either 90 or 180 μg dosage for 48 weeks experience the target therapeutic benefits of HBeAg seroconversion, HBV-DNA <5.0 log copies/mL and ALT ≤40 U/L. An overseas comparative study of three treatment regimens for HBeAg negative patients (Peg-IFNα-2a for 48 weeks,

Peg-IFNα-2a plus lamivudine see more for 48 weeks, and lamivudine only for 48 weeks) reported ALT normalization rates of 59%, 60% and 44% respectively, and HBV DNA negative conversion rates of 43%, 44% and 29% respectively at 24 weeks after finishing treatment.[22] Thus, the Peg-IFNα-2a groups demonstrated better results on both parameters. The long term benefits (negative HBV DNA and normal ALT levels at 72 weeks) were likewise stronger in the two Peg-IFNα-2a groups (15%

and 16% compared to 6% for lamivudine only), although the effect tended to be less sustained overall compared to HBeAg positive patients. The HBV DNA levels <400 copies/mL were found in 19% of patients, and HBsAg elimination was observed in 3%.[22] Meanwhile, a study of 61 patients with HBeAg negative chronic active hepatitis B in Japan compared the therapeutic effects from Peg-IFNα-2a dosages of 90 μg (32 patients) and 180 μg (29 patients). In terms of virological benefits, the target HBV DNA levels at finishing treatment (<4.3 log copies/mL) was achieved in 78.1% of the 90 μg

group and 93.1% of the 180 μg group. After 24 weeks, these figures had fallen to 37.5% and 37.9% respectively, whereas the biochemical target (ALT ≤40 U/L) was achieved in 68.8% and 65.5% of patients respectively.[9] It should be noted that, as with the HBeAg positive study, the overwhelming majority of the patients in this study (58/61; 95%) were <50 years of age. A long term follow-up study of 230 HBeAg negative patients treated with Peg-IFNα-2b (with or without MCE lamivudine) reported HBV DNA negative conversion (DNA <4.0 log copies/m) in 21% of patients after five years, and HBsAg elimination in 5% after one year and 12% after five years.[23] Meanwhile, an Italian study of 128 genotype D HBeAg negative patients administered Peg-IFNα-2a over an extended period of 96 weeks (180 μg for 48 weeks then 135 μg for 48 weeks) reported 29% of cases reaching the virological target HBV DNA levels of <2000 IU/mL. It can be seen that this is considerably higher than the corresponding figure of 12% for the 48 week treatment regimen.