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已发表论文
聚乙二醇干扰素α诱导慢性乙型肝炎病毒感染特殊人群的功能性治愈：当前趋势、挑战与展望
Authors Zhang Y , Li Y, Lian JQ, Kang W
Received 30 August 2025
Accepted for publication 14 November 2025
Published 22 November 2025 Volume 2025:19 Pages 10411—10422
DOI https://doi.org/10.2147/DDDT.S564254
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Solomon Tadesse Zeleke
Ye Zhang,1,* Yu Li,2,* Jian-Qi Lian,1 Wen Kang1
1Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, 710038, People’s Republic of China; 2Department of Infectious Diseases, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, 710068, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wen Kang, Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Baqiao District, Xi’an, Shaanxi, People’s Republic of China, Email 82399536@qq.com Jian-Qi Lian, Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Baqiao District, Xi’an, Shaanxi, People’s Republic of China, Email lianjq@fmmu.edu.cn
Abstract: Chronic hepatitis B virus (HBV) infection affects 257 million people globally, causing 880,000 deaths annually owing to end-stage liver disease. Current first-line therapies include nucleos(t)ide analogs (NAs) and pegylated interferon-α (PEG-IFN-α). A functional cure, defined as sustained HBsAg loss for ≥ 24 weeks, undetectable hepatitis B e antigen/HBV DNA, and normal liver function, is the ideal and achievable treatment endpoint for chronic HBV infection. This review focuses on PEG-IFN-α-induced functional cure in special populations with chronic HBV infection, including patients with partial response or low-level viremia (LLV), fibrosis or compensated cirrhosis, HBV-related hepatocellular carcinoma (HCC), HBV/human immunodeficiency virus-1 (HIV-1) coinfection, and pediatric patients. PEG-IFN-α enhances the complete virological response and HBsAg loss rate in CHB patients with partial virological responses to NAs or LLV. PEG-IFN-α improves liver histology and promotes liver fibrosis regression in compensated cirrhosis. PEG-IFN-α not only decreases HCC incidence and recurrence but also improves overall survival in patients with HBV-related HCC after curative treatment. Patients living with HBV/HIV-1 coinfection have a high rate of HBsAg loss/seroconversion in response to effective antiretroviral therapy, and the administration of add-on PEG-IFN-α may further increase the rate of HBV functional cure. IFN-α/PEG-IFN-α-based therapy is beneficial for younger children with chronic HBV infection despite the viral load, HBeAg, and liver inflammation status. Adverse events associated with PEG-IFN-α are manageable in specific HBV populations. PEG-IFN-α is a valuable strategy for a functional cure in special populations with chronic HBV infection, supporting clinical decision-making for HBV management.
Keywords: chronic hepatitis B, pegylated interferon-α, functional cure, special population
1Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, 710038, People’s Republic of China; 2Department of Infectious Diseases, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, 710068, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wen Kang, Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Baqiao District, Xi’an, Shaanxi, People’s Republic of China, Email 82399536@qq.com Jian-Qi Lian, Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Baqiao District, Xi’an, Shaanxi, People’s Republic of China, Email lianjq@fmmu.edu.cn
Abstract: Chronic hepatitis B virus (HBV) infection affects 257 million people globally, causing 880,000 deaths annually owing to end-stage liver disease. Current first-line therapies include nucleos(t)ide analogs (NAs) and pegylated interferon-α (PEG-IFN-α). A functional cure, defined as sustained HBsAg loss for ≥ 24 weeks, undetectable hepatitis B e antigen/HBV DNA, and normal liver function, is the ideal and achievable treatment endpoint for chronic HBV infection. This review focuses on PEG-IFN-α-induced functional cure in special populations with chronic HBV infection, including patients with partial response or low-level viremia (LLV), fibrosis or compensated cirrhosis, HBV-related hepatocellular carcinoma (HCC), HBV/human immunodeficiency virus-1 (HIV-1) coinfection, and pediatric patients. PEG-IFN-α enhances the complete virological response and HBsAg loss rate in CHB patients with partial virological responses to NAs or LLV. PEG-IFN-α improves liver histology and promotes liver fibrosis regression in compensated cirrhosis. PEG-IFN-α not only decreases HCC incidence and recurrence but also improves overall survival in patients with HBV-related HCC after curative treatment. Patients living with HBV/HIV-1 coinfection have a high rate of HBsAg loss/seroconversion in response to effective antiretroviral therapy, and the administration of add-on PEG-IFN-α may further increase the rate of HBV functional cure. IFN-α/PEG-IFN-α-based therapy is beneficial for younger children with chronic HBV infection despite the viral load, HBeAg, and liver inflammation status. Adverse events associated with PEG-IFN-α are manageable in specific HBV populations. PEG-IFN-α is a valuable strategy for a functional cure in special populations with chronic HBV infection, supporting clinical decision-making for HBV management.
Keywords: chronic hepatitis B, pegylated interferon-α, functional cure, special population