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Peer-reviewedCC BY 4.0Frontiers in Public Health

Patient-reported treatment burden, communication, and persistence intention during add-on peginterferon alfa-2b therapy for chronic hepatitis B: a cross-sectional study

  • Ning Han1,2,3
  • Huan Liu1,2,3
  • Libo Yan1,2,3
  • Hong Tang1,2,3
  1. 1Center of Infectious Diseases, West China Hospital of Sichuan University
  2. 2Laboratory of Infectious and Liver Diseases, Institution of Infectious Diseases, West China Hospital of Sichuan University
  3. 3Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University
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Abstract

Background: Add-on peginterferon alfa-2b (Peg-IFN) may help reduce hepatitis B surface antigen levels and achieve a functional cure in selected patients with chronic hepatitis B (CHB), but the treatment burden can make a finite course difficult to complete. We examined the patient-reported factors associated with thoughts of discontinuation and intentions to persist with treatment during add-on Peg-IFN therapy.

Methods: This anonymous cross-sectional online survey used outcome-specific analytic populations. All 412 eligible respondents were included in discontinuation-related analyses, and the primary persistence analysis included 289 respondents who were still receiving Peg-IFN. The main outcomes included whether respondents had ever wanted to stop Peg-IFN due to adverse effects and a four-item persistence/value intention score. Psychological distress was assessed using the Patient Health Questionnaire-4 (PHQ-4).

Results: Among 412 eligible respondents, 175 (42.5%) had wanted to stop Peg-IFN because of adverse effects, 136 (33.0%) had asked a physician about dose reduction or discontinuation, and 39 (9.5%) reported actual premature discontinuation. In the adjusted analysis, adverse-effect burden (odds ratio 1.86 per standard deviation (SD), 95% confidence interval 1.37–2.51) and the PHQ-4 score (odds ratio 1.76, 95% confidence interval 1.28–2.41) were associated with a history of adverse-effect-related discontinuation thoughts. Among 289 currently treated respondents, treatment belief ( β = 0.280, 95% confidence interval 0.198–0.362) and physician–patient communication ( β = 0.098, 95% confidence interval 0.017–0.179) were associated with higher persistence/value intention, while the PHQ-4 score was inversely associated with this outcome ( β = −0.081, 95% confidence interval −0.148 to −0.013).

Conclusion: Adverse-effect burden and current psychological distress were associated with a history of adverse-effect-related discontinuation thoughts, whereas treatment belief and physician–patient communication were associated with higher persistence/value intention among patients still receiving therapy. Prospective studies are needed to evaluate whether structured education, symptom and distress screening, and tiered follow-up improve the rates of treatment completion.

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Cite

BibTeXRIS
BibTeX
@article{han2026patientreported,
  title = {{Patient-reported treatment burden, communication, and persistence intention during add-on peginterferon alfa-2b therapy for chronic hepatitis B: a cross-sectional study}},
  author = {Ning Han and Huan Liu and Libo Yan and Hong Tang},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1972004},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1972004/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Patient-reported treatment burden, communication, and persistence intention during add-on peginterferon alfa-2b therapy for chronic hepatitis B: a cross-sectional study
AU  - Ning Han
AU  - Huan Liu
AU  - Libo Yan
AU  - Hong Tang
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1972004
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1972004/full
AB  - Background: Add-on peginterferon alfa-2b (Peg-IFN) may help reduce hepatitis B surface antigen levels and achieve a functional cure in selected patients with chronic hepatitis B (CHB), but the treatment burden can make a finite course difficult to complete. We examined the patient-reported factors associated with thoughts of discontinuation and intentions to persist with treatment during add-on Peg-IFN therapy.  Methods: This anonymous cross-sectional online survey used outcome-specific analytic populations. All 412 eligible respondents were included in discontinuation-related analyses, and the primary persistence analysis included 289 respondents who were still receiving Peg-IFN. The main outcomes included whether respondents had ever wanted to stop Peg-IFN due to adverse effects and a four-item persistence/value intention score. Psychological distress was assessed using the Patient Health Questionnaire-4 (PHQ-4).  Results: Among 412 eligible respondents, 175 (42.5%) had wanted to stop Peg-IFN because of adverse effects, 136 (33.0%) had asked a physician about dose reduction or discontinuation, and 39 (9.5%) reported actual premature discontinuation. In the adjusted analysis, adverse-effect burden (odds ratio 1.86 per standard deviation (SD), 95% confidence interval 1.37–2.51) and the PHQ-4 score (odds ratio 1.76, 95% confidence interval 1.28–2.41) were associated with a history of adverse-effect-related discontinuation thoughts. Among 289 currently treated respondents, treatment belief ( β = 0.280, 95% confidence interval 0.198–0.362) and physician–patient communication ( β = 0.098, 95% confidence interval 0.017–0.179) were associated with higher persistence/value intention, while the PHQ-4 score was inversely associated with this outcome ( β = −0.081, 95% confidence interval −0.148 to −0.013).  Conclusion: Adverse-effect burden and current psychological distress were associated with a history of adverse-effect-related discontinuation thoughts, whereas treatment belief and physician–patient communication were associated with higher persistence/value intention among patients still receiving therapy. Prospective studies are needed to evaluate whether structured education, symptom and distress screening, and tiered follow-up improve the rates of treatment completion.
SN  - 2296-2565
ER  -