The investigators evaluated the safety and efficacy of a short lead-in course (8 weeks) of entecavir followed by combination of entecavir plus peginterferon alfa-2a for 40 weeks.
To determine the efficacy of treatment with 8 weeks of entecavir followed by 40 weeks of both entecavir and peginterferon in the treatment of chronic hepatitis B in hepatitis B "e" antigen (HBeAg) positive adults who are in the immune tolerant phase. To evaluate safety and sustained responses after treatment with entecavir and peginterferon alfa-2a in the treatment of chronic hepatitis B in HBeAg positive adults who are in the immune tolerant phase. A single arm treatment study of 8 weeks of entecavir followed by 40 weeks of both entecavir and peginterferon alfa-2a in adults with HBeAg-positive chronic hepatitis B with normal or near normal alanine aminotransferase (ALT) levels and high serum levels of hepatitis B virus (HBV) DNA ("immune tolerant" HBeAg-positive chronic hepatitis B). All participants followed for 48 weeks after treatment discontinuation (week 96 for those who completed treatment).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Entecavir 0.5 mg daily orally for 48 weeks plus peginterferon 180 µg sq weekly during weeks 9-48 of treatment.
Cedars Sinai Medical Center
Los Angeles, California, United States
Proportion of Participants With HBeAg Loss (Lack of Detectable HBeAg) AND HBV DNA ≤1,000 IU/mL
Lack of data was considered to be treatment failure.
Time frame: End of follow-up (up to 96 weeks)
Incidence of Adverse Events (AEs) Per Person-Year of Observation
The number of AEs includes both AEs and Serious Adverse Events (SAEs). The incidence is calculated as the number of AEs divided by the number of person-years of observation, which is the sum, across all participants, of the number of years between the start of treatment and the end of treatment, or the end of follow-up, respectively.
Time frame: From first treatment to the end of treatment (up to 48 weeks) and the end of follow-up (up to 96 weeks)
Incidence of Serious Adverse Events (SAEs) Per Person-Year
The incidence is calculated as the number of SAEs divided by the number of person-years of observation, which is the sum, across all participants, of the number of years between the start of treatment and the end of treatment, or the end of follow-up, respectively.
Time frame: From first treatment to the end of treatment (up to 48 weeks) and the end of follow-up (up to 96 weeks)
Proportion of Participants With HBeAg Loss
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBeAg Loss
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With HBeAg Seroconversion
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBeAg Seroconversion
Time frame: End of follow-up (up to 96 weeks)
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University of California Los Angeles
Los Angeles, California, United States
California Pacific Medical Center
San Francisco, California, United States
University of California San Francisco
San Francisco, California, United States
Queen's Medical Center
Honolulu, Hawaii, United States
NIH Clinical Center
Bethesda, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
University of Michigan Health System
Ann Arbor, Michigan, United States
University of Minnesota
Minneapolis, Minnesota, United States
...and 11 more locations
Proportion of Participants With HBsAg Loss
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBsAg Loss
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With HBsAg Seroconversion
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBsAg Seroconversion
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With Alanine Aminotransferase (ALT) <45 U/L for Men, <30 U/L for Women
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With ALT <45 U/L for Men, <30 U/L for Women
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With ALT Normalization (Men <30 U/L, Women <20 U/L)
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With ALT Normalization (Men <30 U/L, Women <20 U/L)
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With HBV DNA ≤1000 IU/mL
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBV DNA ≤1000 IU/mL
Time frame: End of follow-up (up to 96 weeks)
Proportion of Participants With HBV DNA <20 IU/mL
Time frame: End of treatment (up to 48 weeks)
Proportion of Participants With HBV DNA <20 IU/mL
Time frame: End of follow-up (up to 96 weeks)
Absence of Detectable Antiviral Drug-resistance HBV Mutations
HBV drug resistance variant testing was performed at the CDC laboratory. The sequences of the HBV polymerase spanning nucleotide positions 311-1021 were determined by Sanger sequencing. Drug resistance mutations that were tested in this study included L80VI, L82M, T128N, W153Q, F166L, I169T, V173L, L180M, A181TV, T184ACFGILMS, V191T, A194T, A200V, S202ETV, M204IV, V207I, N236T, M250ILV, and G145R.
Time frame: End of treatment (up to 48 weeks)