HBsAg Clearance And Influencing Factors After Treatment Of NAs In Patients With CHB HBeAg Positive

ObjectiveTo study the HBs Ag clearance rate and its influencing factors in patients with chronic hepatitis B HBe Ag-positive after long-term nucleoside(acid)analogue therapy.MethodsA retrospective analysis of 412 HBe Ag-positive patients receiving nucleoside(acid)analogues was divided into treatment durations <5-year group and treatment duration ≧5-year group according to the duration of treatment,and the Influencing factors of HBs Ag clearance of each group was observed.ResultsThe median follow-up time was 5.05(3.50-7.00)years.A total of 15 patients with HBs Ag clearance were observed.The annual clearance rate was 5.00%,including 3 cases(1.84%)in the treatment period <5 years,and≧5 years in the treatment period.For 12 patients(6.51%),there was a statistically significant difference in the annual clearance of HBs Ag between the two groups(P=0.000).Between the different nucleotide analogue treatment groups,10 patients(7.79%)in the LAM+ADV group,2 patients(1.45%)in the ETV group,and 3 patients(4.5%)in the Ld T group.After adjusting the test level,the two groups were compared.The HBs Ag clearance rate between the LAM +AD group and the ETV group was at a critical value(P=0.012),and there was no significant difference in HBs Ag clearance between the other groups.Univariate analysis showed that HBs Ag clearance and initial drug age were greater than 45.5 years(χ~2=4.652,P=0.031),baseline HBs Ag titer levels were below 2.94 log10 IU/m L(χ~2=33.965,P=0.000),follow-up time≧5.65(χ~2=6.141,P=0.013).Multivariate analysis showed that baseline HBs Ag titer levels below 2.96 log10 IU/m L and baseline HBV DNA load below 4 log10 IU/m L were independent influencing factors for HBs Ag clearance(HR=8.428,95% CI=2.767-25.668,P=0.000).ConclusionsNucleoside(acid)analogue antiviral therapy has low HBs Ag clearance in patients with chronic hepatitis B;HBs Ag clearance is related to the age of patients with initial antiviral therapy,related to host immune response,antiviral ability and long-term continuous medication,with baseline HBs Ag drops The level of hepatitis and the load of hepatitis B virus are closely related.