Evaluation Of The Efficacy Of Antiviral Therapy In Patients With Low/Non-virulinaemic Hepatitis B Cirrhosis At First Treatment

Objective:To investigate the effect of primary antiviral therapy in patients with hepatitis B cirrhosis with low/no viremia(HBV DNA ≤ 2000IU/ml).Methods: Clinical data of 426 patients with hepatitis B cirrhosis with low/no viremia were retrospectively collected.Treatment group(n=366)and control group(n=60)were divided according to whether antiviral treatment was available.The treatment group was divided into 5 groups according to the duration of antiviral treatment:6 months(n=128),12 months(n=104),18months(n=47),24 months(n=45)and 30-36 months(n=42).According to the stage of cirrhosis,the 6-month group and the 12-month group were divided into a compensatory group(n=50,n=55)and a decompensated group(n=78,n=49).The clinical characteristics of each group were compared before and after follow-up.The treatment group and the control group were compared before and after treatment.Results:Treatment group and control group were comparable(gender,age(P>0.05)):In the antiviral treatment group,the 6-month HBeAg negative conversion rate was 9.57%,HBV DNA negative conversion rate was 20.67%,ALB increased,CTP score decreased,the morbidity of gastrointestinal bleeding decreased by 7.81%,the morbidity of ascites decreased by 14.84%,and the morbidity of spontaneous peritonitis decreased by 17.19%(P < 0.05).In 12 months,HBeAg negative conversion rate was 18.09%,HBV DNA negative conversion rate was19.19%,ALT decreased,CTP grade A increased by 8.74%,B increased by 3.88% and C decreased by 12.63%(P<0.05).HBeAg negative rate of 21.74%,HBV DNA negative rate of 17.78%,CTP score decreased,ALB increased(P<0.05)at 18 months,HBeAg negative rate of 29.27%,ALB increased(P<0.05)at 24 months.At 30-36 months,HBeAg negative conversion rate was 60.00% and MELD score was increased(P < 0.05);In the control group,the HBeAg negative conversion rate was 27.66% and MELD score was increased(P<0.05).In the compensated group,the 6-month HBeAg negative conversion rate was 24.44%,AST was increased,MELD score was increased,APRI score was increased,FIB-4 index was increased(P<0.05),the 12-month HBeAg negative conversion rate was 24.49%,ALT was decreased,and the incidence of spontaneous peritonitis was increased by 10.93%(P<0.05).In decompensated group,the HBV DNA negative rate at 6months was 24.32%,the prevalence of gastrointestinal bleeding was decreased by12.66%,the prevalence of ascites was decreased by 32.91%,the prevalence of spontaneous peritonitis was decreased by 34.18%,and the CTP score was decreased(P<0.05).At 12 months,the HBV DNA negative rate was 23.40%,the prevalence of ascites decreased by 38.77%,the prevalence of spontaneous peritonitis decreased by 32.65%,the proportion of CTP grade C decreased by 21.94%,and the ALB increased(P <0.05).Conclusion: Antiviral therapy can significantly reduce the positive rate of HBeAg and HBV DNA,significantly improve liver function,and significantly reduce the incidence of complications of liver cirrhosis in patients with low/no viremia hepatitis B cirrhosis initially treated,and some patients can change from decompensated stage to compensated stage of liver cirrhosis.