HBsAg消失的预后因素与治疗挑战

HBsAg loss with or without seroconversion was observed only in participants who had an HBsAg level below 1000 IU per milliliter at screening, including 60% of the participants who had HBsAg loss at the end of treatment with xalnesiran plus peginterferon alfa-2a. These results are consistent with the hypothesis that a low pretreatment HBsAg level is prognostic for HBsAg loss,20,27 a situation that highlights the challenge of obtaining a functional cure in patients with high HBsAg. Despite the high percentages of participants with HBsAg loss that were observed in the immunomodulatory-therapy groups at the end of treatment, erosion of this response was observed during the follow-up period — a situation that was similar to that seen with other investigational oligonucleotide regimens.20,24–26 Most erosion of HBsAg loss occurred soon after the end of treatment; however, some erosion was observed at later time points. In group 4, the durability of HBsAg loss decreased from 78% to 56% between 24 weeks and 48 weeks after the end of treatment, which underscores the need for a sufficiently long duration of follow-up to assess the durability of HBsAg loss induced by new agents.