Analysis Of The Factors Affecting The Outcome Of HBeAg Seroconversion In Antiviral Monotherapy Naive Hbeag Positive CHB Patients

Background And Objectives Hepatitis B virus e antigen is one seroimmunological mark of hepatitis B virus infection and a symbol of HBV replication actively.At present lots of studies indicated that HBeAg is of great significance for efficacy and prognosis in antiviral therapy of CHB patients.HBeAg seroconversion is one of the endpoints for antiviral therapy in HBeAg positive CHB patients.But some patients can hardly achieve HBeAg seroconversion after a long-term antiviral monotherapy even achieve biochemical response and virological response observed in the real world.But the reason is unknown.The aim of this study is to explore the factors associated with the outcome of hepatitis B virus e antigen serological loss after a long-term antiviral monotherapy naive in chronic hepatitis B patients.Methods Collect the clinical data of chronic hepatitis B(CHB)patients who antiviral monotherapy naive more than 2 years.And analyze the correlations between the HBeAg serological loss and the markers of baseline and week12,week24,week52,2year,3year,4year during therapy period retrospectively.Results 92 antiviral monotherapy naive CHB patients are involved in this study.The HBeAg loss group has a higher TBIL level(P = 0.018),higher APRI score(P = 0.024),and higher HBV DNA undetectable rate at week 24(P = 0.001)compared with HBeAg non-loss group respectively,The differences are statistically significant.APRI score(OR = 1.398,95%CI = 1.034-1.889,P = 0.029)and HBV DNA level at week 24(OR = 0.727,95%CI 0.532-0.991,P = 0.044)are independent impact factors of HBeAg loss by Multivariate binary logistic regression analysis.The long-tern HBeAg loss rate is higher in LDT patients compared with ETV patients(2year: 31.4% VS 14.0%,P = 0.045;3 year: 48.6% VS 21.1%,P = 0.006;4 year: 48.6% VS 26.3%,P = 0.030).Conclusions The baseline TBIL level,APRI score,and HBV DNA undetectable rate at week 24 are associated with HBeAg loss is in CHB patients with long tern antiviral monotherapy naive.Baseline APRI score,HBV DNA level at week 24 are independent factors correlated to HBeAg loss.For HBeAg positive CHB patients with higher APRI score or higher TBIL level at baseline,they maybe should consider switching antiviral scheme as long as HBV DNA remains detectable at week 24 if they expect to achieve a better HBeAg loss rate.LDT is superior to ETV at achieving HBeAg loss in antiviral therapy naive HBeAg positive CHB patients.