The Cohort Study Of Antiviral Therapy In Chronic HBV Infection With Normal Alanine Aminotransferase

Objective(s):To aim the difficulties of antiviral treatment for chronic HBV infection with normal ALT,through the early application of nucleoside(nucleotides)drugs antiviral treatment,for patients with reply,give continuous antiviral treatment,after long-term follow-up,to explore the feasibility and necessity of antiviral treatment for this type of chronic HBV infection.Methods:Based on the study inclusion criteria,there are HBeAg-positive and HBeAg-negative patients according to HBeAg status.According to ALT levels,divided into ALT normal group and ALT ≥ 2 x ULN group.The sustained antiviral treatment are taken for the HBeAg-positive and HBeAg-negative patients with normal ALT.If HBV DNA decline with respect to the baseline<1 log 10IU/ml through 12 weeks or HBV DNA decline with respect to the baseline<21og10IU/ml through 24 weeks,antiviral treatment is suggested to be stopped and immune tolerance is proposed.The antiviral efficacy and differences are evaluated between HBeAg-positive and HBeAg-negative patients with ALT normal and ALT≥2 x ULN after 48 weeks of continuous antiviral therapy and prolonged observation.Results:1.There is no statisticlly significant difference of undetectable serum HBV DNA levels ratio and HBeAg Seroconversion ratio between the HBeAg-positive patients with normal ALT and ALT≥2xULN ones through 48w antivirul theatment.2.There is no statisticlly significant difference of undetectable serum HBV DNA levels ratio between the HBeAg-negative patients with normal ALT and ALT≥2×ULN ones through 48w antivirul theatment.3.There is no statisticlly significant difference of undetectable serum HBV DNA levels ratio between the HBeAg-positive patients with normal ALT and HBeAg-negative ones through 48w antivirul theatment.4.There is no statisticlly significant difference of undetectable serum HBV DNA levels ratio and ALT normalisation between the HBeAg-positive patients with ALI≥2×ULN and HBeAg-negative ones through 48w antivirul theatment.5.There is no statisticlly significant difference in the liver stiffness of each segment in HBeAg-positive patients with normal ALT levels between pre-treatment and after-treatment.The value of liver stiffness decreased and had normal trend in HBeAg-negative patients with normal ALT levels between pre-treatment and after-treatment through 48w antivirul theatment.6.The absolute value of CD3+,CD3+ CD8+,CD 19+ was higher than pretreatment,there is statisticlly significant difference.Conclusion:1.In HBeAg-positive chronic HBV infection with normal ALT patients and except for primary non-response,HBV DNA levels can be significantly reduced and a certain percentage of patients to achieve HBeAg seroconversion by antiviral treatment.There is no difference in efficacy of antiviral treatment compared to ALT2 X ULN ones.It is recommended it is recommended that antiviral therapy should be given to HBeAg-positive chronic HBV infection patients with normal ALT and virological response in the early stage.2.The HBeAg-negative chronic HBV infection with normal ALT patients and the levels of HBV DNA less than undetectable serum HBV DNA levels by antiviral treatment,there is no difference in efficacy of antiviral treatment compared to ALT2 X ULN ones.It is recommended that antiviral therapy should be given to HBeAg-negative chronic HBV infection patients with normal ALT3.There is no statisticlly significant difference in the liver stiffness of each segment in HBeAg-positive patients with normal ALT levels between pre-treatment and after-treatment.The value of liver stiffness decreased and had normal trend in HBeAg-negative patients with normal ALT levels between pre-treatment and after-treatment.These suggesting antiviral therapy can prevent or delay the progression of liver disease and patients benefiting from antiviral therapy.4,After using ganlong,CD3+,CD3+CD8+,CD 19+ absolute values increase compared to those before the treatment,there is statistical significance.It is suggested that the increase of T lymphocyte and B lymphocyte numbers can improve the immune status and be beneficial to the elimination of virus.