{
  "abstract": "Abstract Background Peg-interferon (peg-IFN) plays an increasingly important role in HBV cure strategies, either in combination with novel antivirals, as a lead-in or as consolidation treatment.Objective We aimed to provide estimates of hepatitis B surface antigen (HBsAg) decline and clearance that can be achieved with peg-IFN addition to nucleos(t)ide analogue (NA) therapy.Design This is a post hoc meta-analysis of individual participant data from eight clinical trials involving chronic hepatitis B patients on NA therapy who received peg-IFN add-on. The primary endpoint was HBsAg loss at end of follow-up (EOF, 6–12 months after end of peg-IFN). Secondary analyses focused on HBsAg decline.Results 581 patients were included. At the start of peg-IFN therapy (SOT), 44% were hepatitis B envelope antigen (HBeAg) positive, mean HBsAg level was 3.03 log10 IU/mL (HBsAg<100: 12%; 100–1000: 28%; ≥1000: 60%), and planned duration of peg-IFN was 48 weeks in 496 patients (85%).At EOF, 50 (8.6%) patients achieved HBsAg loss (HBsAg<100/100–1000/≥1000: 37.7/9.8/2.3%, p<0.001) Findings were consistent across ethnicities (Caucasian: 30.0/8.7/3.6%; Asian: 39.3/9.2/2.2%). In patients with SOT HBsAg≥1000 IU/mL, levels <1000 and <100 were achieved in 29.7% and 8.9% at 24 weeks and in 47.5% and 16.3% at 48 weeks of peg-IFN therapy, respectively.Conclusion Peg-IFN add-on results in HBsAg loss in 18% of patients with SOT HBsAg<1000 IU/mL, and in 38% if SOT HBsAg<100 IU/mL. Among patients with higher HBsAg levels, peg-IFN could be used to reduce HBsAg to below thresholds associated with response to novel compounds.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Edo J Dongelmans"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Lesley A Patmore"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, National University Health System, Singapore",
        "Department of Medicine, Yong Yoo Lin School of Medicine, National University of Singapore, Singapore"
      ],
      "name": "Seng Gee Lim"
    },
    {
      "affiliations": [
        "Liver Unit, Hôpital Saint Joseph, Marseille, France",
        "Aix Marseille University, Inserm, IRD, SESSTIM, Sciences Économiques and Sociales de la Santé and Traitement de l’Information Médicale, ISSPAM, Marseille, France"
      ],
      "name": "Marc Bourliere"
    },
    {
      "affiliations": [
        "Department of Infectious Disease, Shanghai Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Shaowen Jiang"
    },
    {
      "affiliations": [
        "Service d’Hépatologie, Hôpital Avicenne, Bobigny, Île-de-France, France",
        "Université Sorbonne Paris Nord, UFR SMBH, Bobigny, France",
        "Cordeliers research center, Sorbonne Université, Inserm, Université de Paris, team « Functional Genomics of Solid Tumors », Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, Paris, France"
      ],
      "name": "Nathalie Ganne-Carrie"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Willem-Pieter Brouwer"
    },
    {
      "affiliations": [
        "Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada",
        "The Toronto Viral Hepatitis Care Network (VIRCAN), Toronto, Ontario, Canada"
      ],
      "name": "Jordan J Feld"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Centre for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China",
        "Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Yuxian Huang"
    },
    {
      "affiliations": [
        "Liver Section,Department of Gastroenterology, Hospital del Mar, Barcelona, Spain",
        "Institut Hospital del Mar D’Investigacions Mèdiques, PSMAR, Barcelona, Spain",
        "Universitat Pompeu Fabra, Facultat de Ciències de la Salut i de la Vida, Barcelona, Spain"
      ],
      "name": "Jose A Carrion"
    },
    {
      "affiliations": [
        "Liver Section,Department of Gastroenterology, Hospital del Mar, Barcelona, Spain",
        "Institut Hospital del Mar D’Investigacions Mèdiques, PSMAR, Barcelona, Spain"
      ],
      "name": "Teresa Broquetas"
    },
    {
      "affiliations": [
        "Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Qiankun Hu"
    },
    {
      "affiliations": [
        "Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada",
        "The Toronto Viral Hepatitis Care Network (VIRCAN), Toronto, Ontario, Canada"
      ],
      "name": "Scott Fung"
    },
    {
      "affiliations": [
        "Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Paris, France"
      ],
      "name": "Fabrice Carrat"
    },
    {
      "affiliations": [
        "Lyon Hepatology Institute (IHU EVEREST), UMR PaThLiv U1350, INSERM, Université Claude Bernard Lyon 1, Hospices civils de Lyon, Lyon, France"
      ],
      "name": "Fabien Zoulim"
    },
    {
      "affiliations": [
        "Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada",
        "Department of Epidemiology, Biostatistics, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands",
        "Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Bettina E Hansen"
    },
    {
      "affiliations": [
        "Department of Infectious Disease, Shanghai Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai, China"
      ],
      "name": "Qing Xie"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands",
        "Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada"
      ],
      "name": "Harry L A Janssen"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"
      ],
      "name": "Milan J Sonneveld"
    }
  ],
  "title": "HBsAg decline and clearance with peg-IFN therapy added to nucleos(t)ide analogues: an individual participant data meta-analysis of prospective trials (PROSPER)",
  "uid": "55609b99-cf09-5cca-978e-a279f7936397"
}