Peginterferon monotherapy in Chronic Hepatitis B infection: Bristol experience.

Background: Interferon therapy has been used in the treatment of Chronic HBV infection (CHBVI) over the last three decades. Recent advances in diagnostics and availability of oral antiviral agents, it has become increasingly challenging to determine whom, when and how to treat.
Methodology: We audited the virologic, serologic, and biochemical response of peginterferon monotherapy in CHBVI. All patients who received peginterferon monotherapy during 2004-2009 in our hepatitis clinic were included. Retrospective review of case notes, radiological, histological, and laboratory results were conducted to record data at the following time points: baseline, 12wks, 24wks, 48wks, and 72 wks.
Results: Of the 66 patients who commenced on therapy for CHBVI, 21(32%) patients received peginterferon monotherapy. Mean age 44±24; Male: female ratio 17:4.18/21(90%) patients completed the intended 48wks course, 3/21 therapy was stopped prematurely due to adverse drug reactions. Based on EASL criteria, 52% showed primary virologic response, 38% overall virologic response, 21% undetectable viral load at some point. The seroconversion rate was 35% and biochemical response (ALT normalisation) was 21%.
Conclusion: Our cohort achieved similar outcomes to the published data. However, based on current NICE recommendations, less than a third of our patients deemed suitable to initiate therapy for CHBVI received peginterferon.