Abstract: Objective The aim of this study was to investigate the 3-year follow-up results of patients with serum HBeAg-positive chronic hepatitis B (CHB) after 48 to 72 week pegylated interferon α-2a (peg-IFN α-2a) treatment. Methods 72 na-ve patients with serum HBeAg-positive CHB were recruited in our hospital between March 2017 and March 2018, and all received peg-IFN α-2a treatment, including 33 patients in group A treated for 48 weeks and 39 patients in group B for 72 weeks. All patients in our series were followed-up for three years. The clinical efficacy, as serum HBsAg disappearance rate, HBeAg disappearance rate, HBeAg seroconversion rate, HBV DNA negative conversion rate and ALT normalization rate were compared between the two groups. The liver stiffness measurement (LSM) was measured by FibroTouch liver transient elastography. The independent impacting factors for serum HBeAg seroconversion were analyzed by Logistics regression analysis. Results At the end of 48 week treatment, there was no significant difference respect to the antiviral efficacy between the two groups (P>0.05); at the end of 72 weeks, serum HBsAg disappearance, HBeAg disappearance, HBeAg seroconversion, HBV DNA loss and ALT normalization rates in group B were 33.3%, 64.1%, 71.8%, 69.2% and 74.4%, much higher than 12.1%, 39.4%, 48.5%, 45.5% and 51.5% (P<0.05) in group A; at the end of two year follow-up, serum HBsAg disappearance, HBeAg disappearance, HBeAg seroconversion, HBV DNA loss and ALT normalization rates in group B were 43.6%, 69.2%, 74.4%, 74.4% and 79.5%, much higher than 21.2%, 42.4%, 51.5%, 48.5% and 54.6% (P<0.05) in group A and at the end of 3 year follow-up, they were 46.2%, 76.9%, 82.1%, 79.5% and 84.6% in group B, also much higher than 27.3%, 57.6%, 60.7%, 60.6% and 72.7% (P<0.05) in group A; at the end of 3 year follow-up, serum HBeAg seroconversion was obtained in 52 cases in our series, and there were significant differences as respect to the ages, antiviral regimen period and serum HBeAg levels at baseline between patients with and without serum HBeAg seroconversion (P<0.05); the multivariate Logistics analysis showed that the age, treatment course of peg-IFN α-2a and baseline HBeAg levels were the independent factors affecting HBeAg seroconversion (P<0.05). Conclusion The prolongation of antiviral course of peg-IFN α-2a might improve the clinical efficacy, and the regimen has a good safety and could enhance the anti-hepatic fibrosis ability.

Key words: Hepatitis B, Pegylated interferon α-2a, HBeAg positive, Therapy, Long-term efficacy