Hepatitis B virus DNA level as predictor of response to therapy with interferon-alpha-2b (PDferon) in chronic hepatitis B infection

Background: to evaluate the strength of association and to determine the best prediction of response in terms of sensitivity and specificity among quantitative baseline hbv-dna levels in blood serum in patients with chronic hepatitis b (chb) infection who treated with interferon-alpha-2b. patients and methods: totally, 78 chb patients with serum hbv-dna>10^5 copies/ml were treated with interferonalpha- 2b (pdferon: pooyesh darou, tehran, iran) for 52 weeks as 5 mu sc. for 24 weeks in hbeag(+) and 48 weeks for hbeag(-) at baseline of study in tehran, iran. serum hbv-dna level using cobas amplicor hbv monitor test and hbeag status were assessed at baseline and end of 6-months follow-up. sustained response (sr) (n=42, 56%) was defined by hbeag seroconversion (n=12), or with a decrease in hbv-dna >10^5 copies/ml to undetectable value (n=33), or chemical response (n=20). results: higher pretreatment hbv-dna levels have a significant relationship with better response to treatment in hbeag (+) (r=0.7, p=0.04). positivity of hbeag in sr was a better predictor of chemical response in our patients, when compared to hbeag negative (sr: 85% vs. 15%, respectively). at end of follow up, hbeag (-) patients revealed more decrease in hbv-dna levels than hbeag (+) (412 vs. 290 ×10^5 copies/ml, p<0.05). sensitivity of hbv-dna in hbeag (+) was more than hbeag(-) (75% vs. 62%), but specificity was less in hbeag(+) (58% vs. (5%). area under roc was 0.63 in hbeag (-). conclusion: higher pretreatment hbv-dna levels have a significant relationship with better response to treatment in hbeag positive patients of chb. although hbv-dna in hbeag negative was decreased significantly from baseline to end of follow-up, monitoring with sensitive quantitative baseline hbv-dna measurement in these patients was not a better predictor of sr than hbeag positive.