Journal of Clinical Hepatology
This article investigates the influencing factors of HBsAg clearance in patients with HBeAg-negative chronic hepatitis B (CHB) treated with pegylated interferon alpha-2b (PEG-IFN-α-2b) combined with nucleoside analogs (NUC), and constructs a predictive model. The study includes 127 patients, analyzing the dynamic changes of multiple indicators at baseline and during treatment, finding that treatment experience, HBsAg baseline level, the decrease in HBsAg at 12 and 24 weeks of treatment, the maximum ALT value, and the minimum TSH value are significantly related to HBsAg clearance. Multivariate logistic regression shows that low-level TSH (≤1.26 μIU/mL) is an independent predictor of HBsAg clearance, suggesting that thyroid function changes may reflect immune activation status and affect antiviral efficacy. In addition, the study innovatively incorporates easily accessible clinical indicators such as TSH, AFP, and blood routine into the analysis, improving the practicality and scalability of the predictive model. Compared with previous studies, this article systematically evaluates the predictive value of TSH in interferon treatment and proposes a clinically operational cutoff value, providing a basis for individualized treatment. The research results help to screen the advantageous population suitable for PEG-IFN-α-2b treatment, improve the clinical cure rate, and reduce unnecessary drug exposure and economic burden.
This study retrospectively analyzes the clinical data of HBeAg-negative chronic hepatitis B (CHB) patients receiving PEG-IFN-α-2b combined with nucleoside analogs (NUC) treatment, aiming to explore the key factors affecting HBsAg clearance at 48 weeks and provide a basis for clinical cure. HBsAg clearance is a core indicator of clinical cure for CHB, closely related to improving liver function and reducing the risk of liver cirrhosis and liver cancer. The study selects independent predictors such as HBsAg baseline value, the decrease in HBsAg at 12 weeks of treatment, the maximum ALT value, and the minimum TSH value through univariate and multivariate logistic regression analysis, and constructs a combined predictive model with an AUC of 0.921, significantly better than a single indicator, with high diagnostic efficacy. Notably, the study finds that TSH ≤1.26 μIU/mL during treatment is significantly associated with HBsAg clearance, suggesting that thyroid function changes may reflect the intensity of interferon-induced immune response, providing a new perspective for efficacy monitoring. This model helps in individualized treatment decisions, improving cure efficiency while controlling adverse reactions and economic burden. The study plans to expand the sample size and conduct multi-center validation to enhance applicability.
Objective: To investigate the predictive factors for the occurrence of HBsAg clearance in patients with HBeAg-negative chronic…
