Factors associated with persistent positive in HBV DNA level in patients with chronic Hepatitis B receiving entecavir treatment

作者全名："Li, Jun; Dong, Xiao-Qin; Cao, Li-Hua; Zhang, Zhan-Qing; Zhao, Wei-Feng; Shang, Qing-Hua; Zhang, Da-Zhi; Ma, An-Lin; Xie, Qing; Gui, Hong-Lian; Zhang, Guo; Liu, Ying-Xia; Shang, Jia; Xie, Shi-Bin; Liu, Yi-Qi; Zhang, Chi; Wang, Gui-Qiang; Zhao, Hong"

作者地址："[Li, Jun; Liu, Yi-Qi; Zhang, Chi; Wang, Gui-Qiang; Zhao, Hong] Peking Univ First Hosp, Ctr Liver Dis, Dept Infect Dis, Beijing, Peoples R China; [Dong, Xiao-Qin] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept & Inst Infect Dis, Wuhan, Hubei, Peoples R China; [Cao, Li-Hua] Third Hosp Qinhuangdao, Dept Hepatol, Qinhuangdao, Peoples R China; [Zhang, Zhan-Qing] Fudan Univ, Shanghai Publ Hlth Clin Ctr, Dept Infect Dis, Shanghai, Peoples R China; [Zhao, Wei-Feng] Xinxiang Med Univ, Affiliated Hosp 3, Dept Infect Dis, Xinxiang, Peoples R China; [Shang, Qing-Hua] 88 Hosp Chinese Peoples Liberat Army PLA, Dept Hepatol, Jinan, Peoples R China; [Zhang, Da-Zhi] Chongqing Med Univ, Affiliated Hosp 2, Dept Infect Dis, Chongqing, Peoples R China; [Ma, An-Lin] China Japan Friendship Hosp, Dept Infect Dis, Beijing, Peoples R China; [Xie, Qing; Gui, Hong-Lian] Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Dept Infect Dis, Shanghai, Peoples R China; [Zhang, Guo] Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Gastroenterol, Nanning, Peoples R China; [Liu, Ying-Xia] Third Peoples Hosp Shenzhen, Dept Infect Dis, Shenzhen, Peoples R China; [Shang, Jia] Peoples Hosp Henan, Dept Infect Dis, Zhengzhou, Peoples R China; [Xie, Shi-Bin] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Infect Dis, Guangzhou, Peoples R China; [Wang, Gui-Qiang] Zhejiang Univ, Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Zhejiang, Peoples R China; [Wang, Gui-Qiang; Zhao, Hong] Peking Univ Int Hosp, Dept Hepatol, Beijing, Peoples R China"

通信作者："Wang, GQ; Zhao, H (通讯作者)，Peking Univ First Hosp, Ctr Liver Dis, Dept Infect Dis, Beijing, Peoples R China.; Wang, GQ (通讯作者)，Zhejiang Univ, Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Zhejiang, Peoples R China.; Wang, GQ; Zhao, H (通讯作者)，Peking Univ Int Hosp, Dept Hepatol, Beijing, Peoples R China."

来源：FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY

ESI学科分类：MICROBIOLOGY

WOS号：WOS:001016501000001

JCR分区：Q1

影响因子：4.6

年份：2023

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：chronic hepatitis B; persistant viremia; HBV DNA; anti-hepatitis B virus core antibody; fibrosis; carcinoma

摘要："IntroductionThe clinical significance of persistent positive in Hepatitis B Virus (HBV) DNA level in patients receiving antiviral therapy is not well known. We investigated factors associated with persistent viremia (PV) in patients with chronic hepatitis B (CHB) given 78-week entecavir. MethodsA total of 394 treatment-naive CHB patients who had undergone liver biopsy at baseline and week 78 of treatment were analyzed in this prospective multicentre study. We identified patients with PV (above the lower limit of quantification, 20 IU/ml) after 78 weeks of entecavir therapy. Stepwise, forward, multivariate regression analyses of specified baseline parameters were apllied to identify factors associated with PV. Futhermore, we assessed the incidence of hepatocellular carcinoma (HCC) in all patients using models of the risk of HCC development. ResultsOf the 394 patients, 90 (22.8%) still with PV after 78-week antiviral treatment. Factors associated significantly with PV (vs complete virological response, CVR) were HBV DNA level & GE;8 log10 IU/mL (OR, 3.727; 95% CI, 1.851-7.505; P < 0.001), Anti-HBc level < 3 log10 IU/mL (OR, 2.384; 95% CI, 1.223-4.645; P=0.011), and HBeAg seropositivity (OR, 2.871; 95% CI, 1.563-5.272; P < 0.001). Patients with PV were less likely to have fibrosis progression and HCC development than those with the CVR. Of the 11 HBeAg-positive patients with HBV DNA level & GE;8 log10 IU/mL and Anti-HBc level < 3 log10 IU/mL at baseline, 9 (81.8%) had persistent positivity in HBV DNA level and 0 had fibrosis progression at week 78 of treatment. DiscussionIn conclusion, HBV DNA level & GE;8 log10 IU/mL, Anti-HBc level < 3 log10 IU/mL and HBeAg seropositivity at baseline contribute to PV in patients with CHB receiving 78-week antiviral treatment. In addition, the rate of fibrosis progression and the risk of HCC development in patients with PV were kept low. The complete protocol for the clinical trial has been registered at clinicaltrials.gov (NCT01962155 and NCT03568578)."

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