A189 A RETROSPECTIVE ANALYSIS OF OUTCOMES ASSOCIATED WITH PEGYLATED-INTERFERON (PEG-IFN) TREATMENT IN CHRONIC HEPATITIS B (CHB)
Notice bibliographique
Résumé
PEG-IFN is first-line therapy for CHB offering the advantage of a finite treatment, but is rarely used due to concerns about tolerability and efficacy. Nucleot(s)ide analogues (NUC) therapy are well tolerated but require prolonged therapy, with significant cost as well as potential for long-term adverse effects. We aim to assess tolerability and long term outcomes in treatment-naive patients who received PEG-IFN for CHB. The primary outcome assessed was durability of off-treatment response (i.e. HBV DNA<2000 IU/mL, normal ALT). Secondary outcomes assessed included the proportion of those who required subsequent NUC therapy, quantitative HBV surface antigen (qHBsAg) levels, and the proportion with side effects. In this retrospective cohort study, CHB patients who received antiviral therapy from January 1st, 2007 - July 1st, 2017 were identified via the Calgary Liver Unit Hepatitis B database. Data collected included age, sex, ethnicity, FibroScan® results, labs (HBV DNA, genotype, qHBsAg, ALT), total treatment duration, on treatment virological response (HBV DNA and qHBsAg if available) and reported side effects. Patients co-infected with hepatitis D treated with Peg-IFN (n=4) were excluded. In total, 893 patients were started on a NUC, of which 50 (5.6%) patients received PEG-IFN therapy, including 3 currently on treatment who were excluded. The patients’ had the following demographics: median age 43 ± 9.3 years, 72.3% male, 80.8% East Asian, and 57% with unknown genotype. 70.2% (33/47) completed the 48 week course of PEG-IFN therapy. From the 29.2% (14/47) who discontinued interferon early, 64.2% did so due to treatment failure and 21.4% due to side effects. 21/47 (44.7%) who received PEG-IFN did not require subsequent NUC treatment during median follow-up of 33.9 months (±27.5,range 0.9–82.1). 85.7% had normal ALT and 61.9% had DNA levels <2000 IU/mL on most recent follow-up. 55% (26/47) of patients treated with PEG-IFN had a virological and biochemical rebound requiring initiation of a NUC within a median of 18.7 months (±15.6, range 3.2–55.4) post PEG-IFN treatment. In those with sustained response to Peg-IFN, 16/21 had available end of treatment qHBsAg that showed that 8/16 (50%) had levels <1000 IU/mL (median 986.5 ± 1973.3, range 1.2-6384). 24/26 patients who failed PEG-IFN had end of treatment qHBsAg that showed 5/24 (20.8%) had levels <1000 IU/ml (median 3449.5 ± 13661.5, range 3.9-63511). Difference between the two groups was not statistically significant. A significant proportion (44.7%) of patients treated with Peg-IFN showed a SVR, including low qHBsAg levels (<1000 IU/mL), indicating robust immune control of HBV. Careful patient selection and adherence to treatment discontinuation rules based on qHBsAg levels will optimize management usage of PEG-IFN therapy for CHB. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».