TY  - JOUR
T1  - Longitudinal Lipid Changes During 144-week PegIFNα-based Therapy in Chronic Hepatitis B: A Retrospective Cohort Study 
AU  - Shahab, Rehman
AU  - Wang, Siyao
AU  - Faiza, Ahmad
AU  - Dong, Keyang
AU  - Zuo, Liping
AU  - Qu, Zhan
AU  - Ma, Li
AU  - Li, Fangfang
AU  - Abdulgani, S. Abdulaziz
AU  - Li, Jing
AU  - Ye, Feng
AU  - Liu, Yi
JF  - Journal of Translational Gastroenterology
VL  - 
IS  - 000
SN  - 2994-8754
SP  - 
EP  - 
Y1  - 2026-12-30
DO  - 10.14218/JTG.2026.00031
UR  - https://www.xiahepublishing.com/2994-8754/JTG-2026-00031
AB  - Background and objectives 
Pegylated interferon alpha (PegIFNα) has been associated with altered lipid metabolism, but long-term lipid trajectories in chronic hepatitis B remain poorly characterized. We evaluated lipid profiles and virological parameters during 144 weeks of PegIFNα-based therapy.
Methods
This single-center retrospective cohort study included 129 patients with chronic hepatitis B who completed 144 weeks of PegIFNα monotherapy, PegIFNα plus tenofovir alafenamide, or PegIFNα plus entecavir. Serum lipids, hepatitis B surface antigen (HBsAg), hepatitis B e antigen, and hepatitis B virus DNA were assessed at baseline and weeks 24, 48, 72, 96, and 144. Within-patient changes were analyzed with paired tests. Associations between early lipid changes and on-treatment HBsAg seroclearance at week 144 were examined with logistic regression.
Results
From baseline to week 144, mean high-density lipoprotein cholesterol (HDL-C) increased by 0.10 ± 0.25 mmol/L (95% confidence interval, 0.06 to 0.15; P < 0.001) and mean total cholesterol decreased by 0.15 ± 0.41 mmol/L (95% confidence interval, −0.22 to −0.08; P < 0.001). Changes in triglycerides, low-density lipoprotein cholesterol, and the triglyceride-to-HDL-C ratio were not significant. HDL-C declined early and later recovered above baseline. At week 144, 37 patients (28.7%) achieved on-treatment HBsAg seroclearance (≤ 0.05 IU/mL). Of the 34 patients with HBsAg seroclearance at week 96, 13 had detectable HBsAg again at week 144. Early lipid changes were not associated with this endpoint.
Conclusions
HDL-C shows an early decline followed by recovery above baseline, whereas total cholesterol decreases modestly, with no significant net changes in triglycerides, low-density lipoprotein cholesterol, or the triglyceride-to-HDL-C ratio. Early lipid changes are not significantly associated with on-treatment HBsAg seroclearance. The durability of HBsAg loss requires post-treatment follow-up.