Analysis Of Related Factors Of HBsAg Decline Rate During The Treatment Of HBeAg-negative Chronic Hepatitis B With Pegylated Interferon-α-2b

Objective:Interferon is the most likely drug that can achieve clinical cure of chronic hepatitis B.During the treatment of HBeAg-negative chronic hepatitis B with polyethylene glycol interferon-α-2b,there is a difference in the rate of decrease of HBsAg in patients with chronic hepatitis B.Collect the laboratory test results of patients’ treatment baseline and continuous follow-up for 24 weeks,divide them into 6 groups according to the decline rate of HBsAg,and analyze which factors will affect the decline rate of HBsAg,so as to provide more guidance for clinical work.Methods:The clinical data of 124 patients with HBeAg-negative chronic hepatitis B treated with pegylated interferon-α-2b in the infection Department of the first affiliated Hospital of Zhengzhou University from September 2019 to February 2021 were analyzed retrospectively.The patients were divided into 6 groups according to the percentage of HBsAg decline compared with the baseline(i.e.HBsAg decline rate)at 24 weeks of treatment,namely,group 1(HBsAg decreased by≤10%),group 2(>10%,≤30%),group 3(>30%,≤60%),group 4(>60%,≤90%),group 5(>90%and HBsAg>0.05IU/mL at 24 weeks),and group 6(HBsAg ≤0.05IU/mL at 24 weeks).The parameters of ALT,AST,GGT and HBsAg were recorded at baseline and at 4 weeks,8 weeks,16 weeks and 24 weeks of follow-up,and the changes of HBV DNA,albumin and bilirubin were recorded at the same time.The statistical analysis software SPSS 22.0 was used to analyze.The counting data were described by mean and percentage,and the differences between groups were compared by χ~2 test,corrected χ~2 and Fisher exact probability method,respectively.The grade data can be described by means and percentages,as well as median and quartile,and the differences between the two groups were analyzed by Mann-Whitney U test.Finally,the decreasing rate of HBsAg was taken as the dependent variable,and the single factor P<0.1 was included in the multifactor ordered logistic regression,and the parallel line test was carried out.The test level was α=0.05,and the difference was statistically significant(P<0.05).Results:1.There was no significant difference in age stratification and whether the initial ALT,AST,and GGT were abnormal among different HBsAg decline rates(P<0.05).There were significant differences in gender and initial HBsAg stratification among different treatment groups(P<0.05).2.During the treatment,there were significant differences in whether ALT increased the initial HBsAg stratification and whether the initial ALT and AST were abnormal or not(P<0.05).In the course of treatment,there was a significant difference in the positive rate of initial AST among the groups with or without increase of AST(P<0.05).During the treatment,there was no significant difference in gender,age stratification,initial HBsAg stratification,and whether the initial ALT,AST,and GGT were abnormal among the groups with or without GGT increase(P>0.05).3.There were significant differences in the increase of ALT,AST and GGT among different HBsAg decline rates during treatment(P<0.05).4.In multivariate Logistic regression analysis,there was no significant difference in whether the initial AST abnormal and the increase of ALT and AST among different HBsAg decline rate groups(P=0.139,0.677,0.293,respectively,>0.05).There were significant gender differences among different HBsAg decline rates(regression coefficient=1.326,Z=3.296,P=0.001<0.01,OR=3.767).There were significant differences in initial HBsAg stratification among different HBsAg decline rate groups(regression coefficient=-0.765,Z=-3.831,P=0.000<0.01,OR=0.465).There was significant difference in whether the initial ALT abnormal among different HBsAg decline rate groups(regression coefficient=1.549,Z=2.813,P=0.005<0.01,OR=4.705).There was significant difference in the increase of HBsAg in the course of treatment among different groups of GGT decline rate(regression coefficient=1.169,Z=3.207,P=0.001<0.01,OR=3.219).Conclusion:1.During the treatment of CHB with pegylated interferon-α-2b,the decrease rate of HBsAg in women was faster than that in men.2.HBsAg decreased faster in patients with low initial HBsAg levels.3.HBsAg decreased faster in patients with initial ALT positive.4.HBsAg decreased faster in patients with elevated GGT levels during treatment.