Clinical Study Of HbsAg Low-level Nucleoside (acid)analogues Treatment Of Chronic Hepatitis B Patients Combined With Long-acting Interferon Therapy

Objective Objective To observe the efficacy of PEG IFN α-2b in the treatment of chronic hepatitis B(CHB)patients with low level of HBsAg after nucleoside(acid)analogue(NAs)treatment,and to analyze the influence and predictive factors of HBsAg clearance,and to compare the efficacy difference between the combined treatment and continuous NAs monotherapy.Methods 53 CHB patients with serum HBsAg<1500IU/ml after NAs treatment for more than 6 months,of which 24 patients were treated with NAs+Peg-IFNα-2b,29 patients continued the original NAs treatment plan,continued treatment for 48 weeks,and regularly monitored the liver Function and hepatitis B virological indicators,observe the clearance rate of serum HBsAg after the end of treatment,and analyze the related factors that affect HBsAg clearance.Results⑴ After 48 weeks of treatment,the combination therapy group HBsAg clearance rate33.3%(8/24),significantly higher than 0% NAs monotherapy group(Z =-3.36,P =0.001);⑵ The level of HBsAg gradually decreased with the time of medication.The reduction rate of the combined treatment group was 318(109,499.59)IU/ml,which was significantly higher than that of the NAs single-drug group at 72.6(-9.25,303.84)IU/ml(Z=-3.30,P=0.001);⑶ Baseline HBsAg <327IU / ml to have a clearance of HBsAg completed 48 weeks of treatment effect prediction(P = 0.028),AUC was 0.828,cut off value of 327 IU / ml, a sensitivity of 75% and specificity of 87.5%;⑷ HBsAg clearance in patients with abnormal baseline ALT was significantly higher than in patients with normal ALT levels(80% vs 21%)(χ2 = 6.924,P = 0.025);⑸ The combined application of Peg-IFNα-2b treatment is more likely to have a transient increase in ALT than NAs monotherapy(45.8%vs7.1%,χ2=6.126, P=0.027).