Abstract: Objective To analyze the predictive factors of the therapeutic effects of interferons (IFNs) and entecavir (ETV)
treatments for 48 weeks in patients with chronic hepatitis B (CHB) positive for HBeAg. Methods This retrospective analysis
compared the treatment efficacy of IFNs and ETV in 129 CHB patients positive for HBeAg. Twenty-seven of the patients were
treated with PEG-IFNα-2a (180 μg once a week, PEG-IFN group), 51 patients with conventional IFNα (5 MIU three times a
week, IFN group), and 51 with ETV (0.5 mg once daily, ETV group) for 48 weeks. Results After completion of the treatment
cycles, the patients in ETV group showed a significantly higher HBV DNA undetectable rate and a significantly lower HBeAg
seroconversion rate than those in PEG-IFN and IFN groups (P<0.05); HBeAg seroconversion rates were similar between
PEG-IFN group and IFN group (χ2=0.709, P=0.400). In PEG-IFN and ETV groups, HBeAg seroconversion rates were not
associated with age, gender, baseline HBeAg, baseline HBV DNA and baseline ALT. In IFN group, HBeAg seroconversion
rates were associated with baseline HBeAg (P=0.048) but not with age, gender, baseline HBV DNA and baseline ALT. In
PEG-IFNα-2a group, ROC analysis showed that the sensitivity and specificity of HBeAg seroconversion at 48 weeks were 0.778
and 0.889, respectively, when the decline rate of HBeAg between baseline and week 24 exceeded 97.81% , with the
corresponding positive and negative predictive values (PPV and NPV) of 0.778 and 0.889, respectively; the sensitivity and
specificity of HBeAg seroconversion at 48 weeks were 0.889 and 0.722, respectively, when the decline rate of HBeAg between
week 12 and week 24 was over 42.75%, with the corresponding PPV and NPV of 0.615 and 0.929, respectively. Conclusions
Treatments with PEG-IFNα-2a and conventional IFNα for 48 weeks can achieve a higher HBeAg seroconversion rate than ETV, but the latter produces a higher HBV DNA
undetectable rate. For PEG-IFNα-2a treatment, the decline rate of HBeAg between baseline and week 24 over 97.81% is the best predicting factor for HBeAg seroconversion at
week 48 in CHB patients positive for HBeAg.