Pegylated Interferon Alfa 2a Treatment in Patients with Chronic Hepatitis B and Genotype D in Jordan

Background & Aims: To evaluate the efficacy of immune-modulation therapy using pegylated interferon Alfa 2a in the treatment of patients infected with HBV. Patients, Methods: 103 patients diagnosed with chronic hepatitis B at the Gastroenterology & Hepatology unit in Al Bashir Hospital Amman-Jordan between the years 2006 and 2013 were treated with pegylated interferon Alfa 2a 180 mcg once weekly for 48 weeks, 54.3% (56/103) were of male gender and 45.6% (47/103) were female.45 (43.6%) patients were HBeAg negative, 58 (56.3%) were HBeAg positive. ALT, HBV DNA levels, HBeAg seroconversion, HBsAg seroconversion were investigated at 12, 24, 36, 48 and 72 weeks. Non responders were defined failure to decrease in the viral load at least 2 logs at 24 weeks of treatment, responders were defined as HBV DNA load less than 2000 IU/ml at week 48, sustained responders were defined as patients who sustained their viral load less than 2000 after 72 weeks of treatment. HBeAg seroconversion was defined as disappearance of HBeAg and seroconvertion to HBeAb. HBsAg clearance was defined as disappearance of HBsAg. HBsAg seroconversion was considered as disappearance of HBsAg and seroconversion to HBsAb. Relapsers were those responders that had HBV DNA increase more than 2000 IU/ml and ALT flair after end of treatment. All patients were of genotype D. Results: 5.8% of treated patients were sustained responders (6/103), of them 33.3% (2/6) were HBeAg negative patients and 66.6% (4/6) were HBeAg positive patients. Non-responders counted 68.9% (71/103), of them 53.3% (24/45) were HBeAg negative patients and 46.6% (21/45) were HBeAg positive patients. Relapsers were 25.2% (26/103) (16 HBeAg negative patients and 10 HBeAg positive patients). One patient seroconverted HBsAg to HBsAb (0.9%), and two patients obtained HBsAg clearance (1.9%). Conclusion: Pegylated interferon therapy for patients with chronic hepatitis B in Jordan showed that the response to this treatment is unsatisfactory, mostly due to high prevalence of genotype D in Jordan. Longer duration of treatment or sequential therapy may be of help in order to obtain more positive results. More studies regarding treatment with immune modulation therapy are warranted to obtain more representative data.