Response guided treatment for peginterferon in chronic hepatitis b

Several baseline predictors that are associated with high response rates to PEG-IFN in CHB have been determined. Nonetheless, even patients with a high chance of achieving a response, are still at risk of non-response. Recently, a lot of effort has been made in discovering on-treatment predictors of response in order to provide solid stopping rules. In HBeAg positive patients the absence of a decline in HBsAg at week 12 provided the best stopping rule for HBV genotype A and D patients, whereas an HBsAg level > 20.000 IU/mL at week 12 was best for genotype B and C patients. For HBeAg negative patients, no HBsAg decline and less than 2 log HBV DNA decline at week 12 provided the best stopping rule, through all major HBV genotypes. Besides these stopping rules based on efficacy, pros and cons, including costs and side-effects of PEG-IFN based treatment, should always be weighed on an individual basis. © 2013 Springer Science+Business Media New York.