Study On Efficacy Of Antiviral Therapy In Patients With Chronic HBV Infection With Normal Liver Function

Objective:1.To test the efficacy of antiviral treatment for inactive HBsAg positive carriers,and to provide clinical evidence for the feasibility of antiviral treatment for inactive HBsAg positive carriers.2.To test the efficacy of antiviral therapy in patients with chronic hepatitis B virus carrying condition(immune tolerance period),so as to explore the feasibility of antiviral therapy in patients with chronic hepatitis B virus carrying condition(immune tolerance period).3.To test the possible factors affecting the efficacy of antiviral therapy for chronic HBV infected patients with normal liver function,and to provide the basis for predicting the efficacy of antiviral therapy.Methods:1.A total of 144 patients with HBV DNA positive chronic HBV infection who visited the Infection Department of the First Affiliated Hospital of Nanchang University from December 2019 to July 2021 were enrolled.According to the HBeAg status,the patients were divided into two parts: 90 patients with HBeAg negative chronic HBV infection and 54 patients with HBeAg positive chronic HBV infection,In each part of the study,the patients were divided into the study group and the control group according to whether the liver function was abnormal.The patients were given ETV or TDF antiviral therapy.The antiviral efficacy of the study group and the control group in each part of the study were compared,and the incidence of adverse reactions was observed.SPSS 25.0 statistical software was used for statistical analysis.Independent sample t test,Mann Whitney U test and chi square test were used for comparison between groups.2.From December 2019 to July 2020,96 chronic HBV infected patients with normal liver function were enrolled in the study group of part I and part II,which were divided into inactive HBsAg carrier group(69 cases)and chronic hepatitis B carrier group(27 cases)according to HBeAg status,analyzing the correlation between HBV pgRNA and virological response after 36 weeks of antiviral treatment in two groups.Result:1.During the follow-up of antiviral therapy in 90 patients with HBeAg negative chronic HBV infection,the virological response rates of inactive HBsAg carrier group(Study Group)and chronic hepatitis B group(control group)were 98.6% and95.2% at 12 weeks,100% and 100% at 24 weeks,100% and 100% at 36 weeks,100% and 100% at 48 weeks,respectively,There was no significant difference in virological response rate between the two groups at each observation time point(P >0.05).There was no seroconversion or virological breakthrough of HBsAg in the two groups during 1-year follow-up.No adverse events and adverse drug reactions were observed in the two groups.2.During the follow-up period,the mean of HBV DNA(lg IU/ml)at each observation point in the chronic hepatitis B virus carrier group(Study Group)and chronic hepatitis B group(control group)were 4.03 and 3.13 at the 12 th week,3.70 and 2.35 at the 24 th week,3.11 and 1.77 at the 36 th week,respectively,There was statistical significance between the two groups at each observation point(P < 0.05).At 36 weeks of follow-up,serum HBV DNA in the study group decreased by 4 lg IU/ml compared with the baseline.The virological response rates of the study group and the control group were 7.4% and 44.4% in the 12 th week,11.1% and 55.6% in the 24 th week,and 25.9% and 74.1% in the 36 th week,respectively,with statistical significance(P < 0.05).During 36 weeks of antiviral treatment,the serum HBeAg conversion rate was 3.70% in the control group.No adverse events and adverse drug reactions were observed in the two groups.3.In 96 cases of chronic HBV infection with normal liver function,there were significant differences in the baseline serum HBsAg and HBV pgRNA between the two groups(P = 0.00 < 0.05).The baseline levels of HBV pgRNA and HBsAg in the inactive HBsAg carrier group were significantly lower than those in the chronic HBV carrier group.There was a significant correlation between baseline pgRNA and virological response(36 weeks)(rs =-0.654),and between baseline HBsAg(rs =-0.676).Conclusion1.The inactive HBsAg carriers can also obtain good virological efficacy.2.In the short term,antiviral therapy is not effective in patients with chronic hepatitis B virus carrying condition(immune tolerance period),but antiviral treatment could reduce the serum HBV DNA level of these patients,but whether it can reduce the risk of liver cirrhosis and liver cancer needs to be further explored.3.The lower the baseline level of HBsAg or pgRNA,the higher the risk of virological response in chronic HBV infected patients with normal liver function.