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

Autor:	Li J; Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China., Dong XQ; Department and Institute of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China., Cao LH; Department of Hepatology, The Third Hospital of Qinhuangdao, Qinhuangdao, China., Zhang ZQ; Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China., Zhao WF; Department of Infectious Disease, Xinxiang Medical University Affiliated Third Hospital, Xinxiang, China., Shang QH; Department of Hepatology, No.88 Hospital of Chinese People's Liberation Army (PLA), Jinan, China., Zhang DZ; Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China., Ma AL; Department of Infectious Disease, China-Japan Friendship Hospital, Beijing, China., Xie Q; Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China., Gui HL; Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China., Zhang G; Department of Gastroenterology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China., Liu YX; Department of Infectious Diseases, The Third People's Hospital of Shenzhen, Shenzhen, China., Shang J; Department of Infectious Diseases, The People's Hospital of Henan, Zhengzhou, China., Xie SB; Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yat Sen University, Guangzhou, China., Liu YQ; Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China., Zhang C; Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China., Wang GQ; Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China.; The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, Zhejiang, China.; Department of Hepatology, Peking University International Hospital, Beijing, China., Zhao H; Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China.; Department of Hepatology, Peking University International Hospital, Beijing, China.
Jazyk:	angličtina
Zdroj:	Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2023 Jun 16; Vol. 13, pp. 1151899. Date of Electronic Publication: 2023 Jun 16 (Print Publication: 2023).
DOI:	10.3389/fcimb.2023.1151899
Abstrakt:	Introduction: The 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. Methods: A total of 394 treatment-naïve 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. Results: Of 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 ≥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 ≥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. Discussion: In conclusion, HBV DNA level ≥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). Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Li, Dong, Cao, Zhang, Zhao, Shang, Zhang, Ma, Xie, Gui, Zhang, Liu, Shang, Xie, Liu, Zhang, Wang, Zhao and China HepB Related Fibrosis Assessment Research Group.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu