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The ideal endpoint of hepatitis B virus(HBV)antiviral therapy is HBsAg loss,a difficult goal to obtain,especially in HBeAg negative patients.Herein,we report the results obtained by the addition of peg-interferonα-2a to a long-lasting nucleos(t)ide analogues therapy in a HBeAg negative,genotype D patient with steadily HBV-DNA negative/HBsAg positive values.In 2002,our Caucasian 44-year-old male patient received lamivudine and,4 years later,added adefovir because of a virological breakthrough.In 2011,considering his young age,liver stiffness(4.3 kPa)and HBsAg levels(3533IU/mL),we added Peg-interferonα-2a for six months(3in combination with nucleos(t)ide analogues followed by 3 mo of Peg-interferonα-2a monotherapy).A decrease of HBsAg levels was observed after 1 mo(1.21log)of Peg-interferon and 3 mo(1.88 log)after the discontinuation of all drugs.Later,a complete clearance of HBsAg was obtained with steadily undetectable HBVDNA serum levels(<9 IU/mL).HBsAg clearance by the addition of a short course of Peg-interferonα-2a represents an important result with clinical and pharmacoeconomic implications,considering that nucleos(t)ide analogues therapy in HBeAg negative chronic hepatitis B patients is considered a long-lasting/life-long treatment.
The ideal endpoint of hepatitis B virus (HBV) antiviral therapy is HBsAg loss, a difficult goal to obtain, especially in HBeAg negative patients. Herein, we report the results obtained by the addition of peg-interferon alpha-2a to a long-lasting nucleos (t) ide analogues therapy in a HBeAg negative, genotype D patient with steadily HBV-DNA negative / HBsAg positive values. In 2002, our Caucasian 44-year-old male patient received lamivudine and, 4 years later, added adefovir because of a virological breakthrough. 2011, considering his age, liver stiffness (4.3 kPa) and HBsAg levels (3533 IU / mL), we added Peg-interferon alpha- 2a for six months (3 in combination with nucleos (t) ide analogues followed by 3 mo of Peg-interferon alpha-2a monotherapy. A decrease of HBsAg levels was observed after 1 mo (1.21 log) of Peg-interferon and 3 mo (1.88 log) after the discontinuation of all drugs. Lot, a complete clearance of HBsAg was with steadily undetectable HBVDNA serum levels (<9 IU / mL). HBsAg clearance by the addition of a short course of Peg-interferon alpha-2a represents an important result with clinical and pharmacoeconomic implications, considering that nucleos (t) ide analogues therapy in HBeAg negative chronic hepatitis B patients is considered a long-lasting / life-long treatment.