IP10 levels linked to HBsAg decline during TDF treatment

By Shreeya Nanda, Senior medwireNews Reporter

Baseline serum interferon-inducible protein 10 (IP10) levels predict hepatitis B surface antigen (HBsAg) reduction in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection treated with tenofovir disoproxil fumarate (TDF), findings indicate.

These results suggest that “IP10 levels can have clinical implications in the management of [chronic HBV] and may lead to novel immunomodulatory approaches”, says the team led by George Papatheodoridis (Athens University Medical School, Greece).

Among the 160 chronic HBV patients who started TDF therapy between 2008 and 2012, HBsAg levels reduced by a median of 0.08, 0.11, 0.24, 0.33 and 0.38 log₁₀ IU/mL at 6, 12, 24, 36 and 48 months, respectively, relative to baseline. There were no significant changes between the 78 patients who had and the 82 patients who had not previously received nucleos(t)ide analogue (NA) treatment.

At the final assessment, 25% and 12% of all study participants attained a minimum 0.5 log₁₀ IU/mL and 1.0 log₁₀ IU/mL reduction in HBsAg levels, respectively.

And the cumulative rates of at least a 0.5 log₁₀ IU/mL decline in HBsAg levels at 12, 24, 36 and 48 months were 8%, 16%, 24% and 41%, respectively. The corresponding rates for a minimum 1.0 log₁₀ IU/mL decline in HBsAg levels were 4%, 10%, 12% and 15%.

In univariate analysis, both baseline HBsAg and IP10 levels were significantly associated with HBsAg reduction of at least 0.5 log₁₀ IU/mL (p=0.004 and p=0.002, respectively), but in multivariate analysis, the association remained significant only for serum IP10 levels (p≤0.001).

Using a previously reported IP10 cutoff of 350 pg/dL, Papatheodoridis et al found that patients with baseline IP10 levels above compared with below the cutoff achieved HBsAg reduction of at least 0.5 log₁₀ IU/mL significantly earlier (p<0.001).

“As HBV can limit the induction of antiviral defence mechanisms in the liver and higher serum IP10 levels probably reflecting an activated immune system are associated with favourable responses in [chronic HBV] patients, induction of IP-10 could represent a potential novel immunomodulatory approach in the treatment of [chronic HBV], as it has been recently tried in other diseases”, the researchers write in the Journal of Viral Hepatitis.

They add: “Additional evaluation of the usefulness of serum IP10 levels in [chronic HBV] patients who achieve HBsAg loss under long-term NA therapy will be of great interest.”

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