Efficacy of NAs in combination with Peg-IFN for functional cure in patients with CHB: a meta-analysis of RCTs.

Ann MedMar 4, 2026 (epub)
Clinical ResearchGastroenterologyOpen access

Yaqin Zhang, Ziyu Zhang, Xinxin Li et al.

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In 30 seconds

This meta-analysis of 16 randomised controlled trials assessed nucleoside (acid) analogues (NAs) combined with pegylated interferon (Peg-IFN) for functional cure in people with chronic hepatitis B. Compared with NAs alone, combination therapy improved HBsAg clearance at end of treatment (EOT; RR 14.05, 95% CI 6.13-32.20) and end of follow-up (EOF; RR 7.70, 95% CI 4.24-13.98). It showed no additional functional-cure benefit over Peg-IFN alone at either time point. Peg-IFN monotherapy was associated with more ALT flares during treatment.

Key findings

  • At EOT, HBsAg clearance was higher with NAs plus Peg-IFN than with NAs alone (RR: 14.05, 95% CI 6.13-32.20).
  • At EOF, HBsAg clearance was higher with combination therapy than with NAs alone (RR: 7.70, 95% CI 4.24-13.98).
  • Combination therapy did not improve HBsAg clearance, seroconversion, or qHBsAg decrease > 1 log10 IU/mL compared with Peg-IFN monotherapy at EOT or EOF.
  • Peg-IFN monotherapy had more ALT flares (ALT > 5 × ULN) during treatment than combination therapy.

Why it matters

The findings distinguish the benefit of adding Peg-IFN to NAs from any incremental benefit over Peg-IFN alone. This comparison may inform interpretation of functional-cure outcomes and treatment trade-offs, while the reported ALT-flare difference highlights a safety outcome relevant to evaluating these regimens.

Source

PubMed · PMID 41777119Free full text on PubMed Central

Published in Ann Med. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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