Clinical outcomes after HBsAg clearance in chronic hepatitis B patients treated with Peg-IFN α:A study with an 11- to 173-month follow-up

To investigate the risk and influencing factors of long-term liver adverse events in chronic hepatitis B patients achieving hepatitis B surface antigen (HBsAg) clearance after pegylated interferon α (Peg-IFN α) treatment, a retrospective analysis was conducted on 456 patients at Beijing Ditan Hospital from 2008 to 2023 who achieved HBsAg clearance and discontinued Peg-IFN α treatment. The baseline was defined as the time of HBsAg clearance and treatment cessation. The endpoint was the first occurrence of liver adverse events (hepatocellular carcinoma or ascites) or last follow-up. Subsequently, we evaluated the incidence and risk factors of liver adverse events, along with changes in liver fibrosis, cirrhosis, and liver function indicators. During a median follow-up of 70 months, the incidence of liver adverse events was 2.30%, hepatocellular carcinoma 1.76%, and ascites 0.55%. Older age and cirrhosis were significant risk factors (HR 1.075 and 41.393, both P < 0.01). The APRI score significantly improved at follow-up compared to baseline (0.53 vs. 0.25, P < 0.001), and cirrhosis prevalence decreased from 5.70% to 0.88% (P < 0.001). In conclusion, patients who achieved HBsAg clearance and discontinued Peg-IFN α treatment have a low risk of liver adverse events, while advanced age and cirrhosis remain major risk factors.