经NAs联合干扰素治疗未达功能性治愈的慢乙肝患者停用干扰素后HBsAg变化模式OA

Objective To characterize the dynamic patterns of serum hepatitis B surface antigen(HBsAg)levels after discontinuation of pegylated interferon-α(Peg-IFN-α)in nucleos(t)ide analogue(NA)-treated patients with chronic hepatitis B(CHB)who failed to achieve functional cure.Methods In this retrospective cohort study,854 CHB patients with baseline HBsAg＜1 500 IU/mL who did not achieve HBsAg clearance after combination therapy with NAs and Peg-IFN-α were included.Longitudinal HBsAg quantification data up to 144 weeks after interferon discontinuation were analyzed.Results The mean age of the cohort was(46.40±12.30)years,and 87.07％were male.Among them,271 patients had baseline HBsAg levels of 500-1 500 IU/mL,and 583 had HBsAg＜500 IU/mL.In the overall popula-tion,HBsAg levels decreased from 2.26 log10 IU/mL(95％CI:2.06-2.47)before interferon therapy to 1.58 log10 IU/mL(95％CI:1.30-1.86)at the time of discontinuation(week 0).HBsAg levels remained relatively stable at week 24(1.52 log10 IU/mL;95％CI:1.26-1.80),followed by a rebound peaking at week 48(2.11 log10 IU/mL;95％CI:1.92-2.30).From weeks 72 to 144,HBsAg levels remained significantly lower than baseline(all P＜0.05).In pa-tients with baseline HBsAg of 500-1 500 IU/mL,HBsAg levels predominantly declined after interferon discontinuation,with over 80％transitioning to the favorable subgroup(HBsAg＜500 IU/mL).During the 144-week follow-up,a total of 135 patients achieved HBsAg clearance,corresponding to a clearance rate of 15.81％.Conclusion HBsAg kinetics after interferon discontinuation in CHB patients who fail to achieve functional cure exhibit substantial heterogeneity.Close longitudinal monitoring is warranted,particularly during the critical window of 24-48 weeks post-discontinuation.These findings provide important insights for individualized post-treatment management strategies.