Di-san junyi daxue xuebao (Jan 2022)

Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B

  • AN Xuan,
  • LIU Shuhong,
  • XIA Lina,
  • WU Guicheng,
  • XIANG Yi,
  • HU Peng,
  • LUO Huan

DOI
https://doi.org/10.16016/j.2097-0927.202107114
Journal volume & issue
Vol. 44, no. 2
pp. 162 – 167

Abstract

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Objective To analyze the clinical features of HBeAg and HBeAb double-positive patients with chronic hepatitis B, and explore the efficacy and outcomes of different antiviral regimens. Methods A total of 158 HBeAg and HBeAb double-positive patients with chronic hepatitis B who met the antiviral treatment criteria were selected from Chongqing Three Gorges Hospital from 2014 to 2018. They were divided into entecavir treatment group (n=52), interferon treatment group (n=49), and control group (without antiviral treatment, n=57) according to the actual treatment regimen, and were followed up for 48 weeks. The efficacy and outcomes of patients were observed and compared among different groups. Results Baseline distribution of HBeAg and HBeAb: among 158 HBeAg/HBeAb double positive chronic hepatitrs B patients, 79 patients had HBeAg≥10, and 79 patieats had HBeAg < 10, each accounting for 50%; HBV DNA level was 4.77±1.23 Lg. Antiviral efficacy: the decrease of HBV DNA level, the HBV DNA negative conversion rate, and the normalization rate of ALT were all better in the entecavir group than the interferon group (P < 0.05), while the decline of HBeAg and HBeAb levels, as well as the HBeAg negative conversion rate were greater in the interferon group (P < 0.05). Clinical outcomes: the proportion of patients who became HBeAg negative or only presented HBsAg and HBcAb positive was significantly larger in the antiviral groups as compared with the control group (P < 0.05), while the control group showed higher proportion of continuous "double-positive" (P < 0.05). In addition, the decrease range of HBeAg-Lg/HBeAb ratio before and after treatment had the greatest value in predicting HBeAg negative conversion. Conclusion For HBeAg and HBeAb double-positive patients with chronic hepatitis B, interferon treatment shows greater advantage in HBeAg negative conversion. Monitoring the decline of HBeAg-Lg/HBeAb is helpful to predict clinical outcome in the double-positive patients.

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