What question did this study set out to answer?

This study aimed to evaluate the efficacy and safety of pegylated interferon alpha for HBsAg clearance in postpartum women with chronic hepatitis B.

May 3, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Efficacy of pegylated interferon alpha in treating postpartum women with chronic hepatitis B virus infection: a multicenter prospective study

HGHongmei GongArmy Medical University MLMing LiuArmy Medical University XZXuqing ZhangArmy Medical University

Puntos clave

This study aimed to evaluate the efficacy and safety of pegylated interferon alpha for HBsAg clearance in postpartum women with chronic hepatitis B.
Prospective multicenter study enrolling 263 postpartum women with chronic HBV infection.
Participants were assigned to Peg-IFNα group or control group based on preference.
Treatment duration for Peg-IFNα was ≥48 weeks with propensity score matching to balance groups.
At week 48, Peg-IFNα group had HBsAg clearance rate of 29.03% compared to 0% in the control group (P < 0.001).
Post-PSM, the clearance rate for Peg-IFNα was 30.43%, still significantly higher than control (0%, P < 0.001).
High baseline HBsAg reduction by week 12 was identified as a strong predictor of clearance at week 48 with AUC ≥0.9.

Resumen

ObjectiveHepatitis B surface antigen (HBsAg) clearance is a key milestone for functional (clinical) cure of chronic hepatitis B virus (HBV) infection. However, data on the efficacy and safety of pegylated interferon alpha (Peg-IFNα) for HBsAg clearance in postpartum women with chronic HBV infection remain scarce. This study aimed to prospectively evaluate the efficacy and safety of Peg-IFNα in promoting HBsAg clearance in this specific population.MethodsA total of 263 HBV-infected postpartum women with a baseline HBsAg levels ≤3000 IU/mL were enrolled. Based on patient preference, they were assigned to either the Peg-IFNα group (n=62, receiving Peg-IFNα monotherapy or combination therapy with nucleos(t)ide analogs NAs) or the control group (n=201, receiving NAs or follow-up only). The duration of Peg-IFNα treatment was ≥48 weeks. Propensity score matching (PSM) was performed to balance baseline characteristics. The primary endpoints were both HBsAg clearance rate and the magnitude of HBsAg decline.ResultsAt week 48, the Peg-IFNα group had significantly higher HBsAg clearance (29.03% 18/62) and seroconversion rates (27.42% 17/62) than the control group (both 0%, P < 0.001). Post-PSM, the Peg-IFNα group still had a significantly higher HBsAg clearance/seroconversion rate (30.43% 14/46) versus the control group (0%, P < 0.001). Subgroup analysis showed that patients with baseline HBsAg < 1000 IU/mL had higher clearance rates (pre-PSM: 39.02% 16/41; post-PSM: 40.00% 12/30). Receiver operating characteristic (ROC) curve analysis identified a ≥ 99.2% HBsAg reduction from baseline to week 12 as a strong predictor of week 48 HBsAg clearance (AUC ≥0.9; sensitivity =0.818; specificity= 1.000).ConclusionPeg-IFNα treatment can achieve high rates of HBsAg clearance and seroconversion in postpartum women with chronic HBV infection. The postpartum period represents a unique and favorable immune window for interferon-based intervention, and patients with baseline HBsAg <1000 IU/mL derive particular benefit from this strategy.

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