Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B

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Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B

Clinical Medicine | 更新时间：2026-01-09

- Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B
- Journal of Army Medical University Vol. 44, Issue 2, Pages: 162-167(2022)
- 作者机构：
  
  1.404000 重庆，重庆大学附属三峡医院肝病科
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院肝胆外科
- 作者简介：
- 基金信息：
  
  the Medical Scientific Research Project of Chongqing Municipal Health and Family Planning Commission(20142136)
- DOI：10.16016/j.2097-0927.202107114
  CLC： R512.62;R969.4;R978.7
- Received：18 July 2021，
  
  Revised：2021-11-03，
  
  Published：30 January 2022
- 稿件说明：
移动端阅览
Xuan AN, Shuhong LIU, Lina XIA, et al. Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B[J]. Journal of Army Medical University, 2022, 44(2): 162-167.
DOI：

Xuan AN, Shuhong LIU, Lina XIA, et al. Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B[J]. Journal of Army Medical University, 2022, 44(2): 162-167. DOI： 10.16016/j.2097-0927.202107114.

摘要

目的

2

分析HBeAg/HBeAb双阳性慢乙肝患者的临床特征，并探讨其抗病毒疗效及临床转归。

方法

2

选取2014-2018年重庆三峡中心医院就诊的HBeAg及HBeAb双阳性慢性乙肝且符合抗病毒治疗标准的患者158例，按实际接收的治疗方案分为恩替卡韦抗病毒组(52例)、干扰素治疗组(49例)、未抗病毒治疗的对照组(57例)，随访48周。观察不同处理组治疗前后疗效及患者的转归情况。

结果

2

基线HBeAg、HBeAb分布情况: 158例HBeAg/HBeAb双阳性慢乙肝患者中，HBeAg≥10患者79例，HBeAb

<

10的患者79例，各占50%；HBV DNA水平为(4.77±1.23)Lg；抗病毒疗效: 恩替卡韦组HBV DNA下降幅度及HBV DNA转阴率、ALT复常率方面均优于干扰素组(

P

<

0.05)；而干扰素治疗组则在HBeAg下降幅度、HBeAb下降幅度以及HBeAg转阴率优于恩替卡韦组(

P

<

0.05)；转归: 与未抗病毒治疗组相比，抗病毒治疗后转为HBeAg阴性的患者比例及转为“仅HBsAg及HBcAb阳性的慢乙肝”患者比例明显增高(

P

<

0.05)；而未抗病毒治疗组持续“双阳性”的比例明显高于抗病毒治疗组(

P

<

0.05)；治疗前后HBeAg-Lg/HBeAb下降幅度预测HBeAg转阴的价值最大。HBeAg/HBeAb双阳性慢乙肝患者HBeAg及HBeAb滴度处于偏低水平，HBV DNA处于相对较低水平；监测HBeAg-Lg/HBeAb下降幅度有助于判断阳性HBeAg转阴率。

结论

2

对于HBeAg/HBeAb双阳性慢性乙肝患者

应用干扰素在HBeAg转阴上具有较大优势；HBeAg-Lg/HBeAb下降幅度在临床转归方面具有良好的预测效能。

Abstract

Objective

2

To analyze the clinical features of HBeAg and HBeAb double-positive patients with chronic hepatitis B

and explore the efficacy and outcomes of different antiviral regimens.

Methods

2

A total of 158 HBeAg and HBeAb double-positive patients with chronic hepatitis B who met the antiviral treatment criteria were selected from Chongqing Three Gorges Hospital from 2014 to 2018. They were divided into entecavir treatment group (

n

=52)

interferon treatment group (

n

=49)

and control group (without antiviral treatment

n

=57) according to the actual treatment regimen

and were followed up for 48 weeks. The efficacy and outcomes of patients were observed and compared among different groups.

Results

2

Baseline distribution of HBeAg and HBeAb: among 158 HBeAg/HBeAb double positive chronic hepatitrs B patients

79 patients had HBeAg≥10

and 79 patieats had HBeAg

<

10

each accounting for 50%; H

BV DNA level was 4.77±1.23 Lg. Antiviral efficacy: the decrease of HBV DNA level

the HBV DNA negative conversion rate

and the normalization rate of ALT were all better in the entecavir group than the interferon group (

P

<

0.05)

while the decline of HBeAg and HBeAb levels

as well as the HBeAg negative conversion rate were greater in the interferon group (

P

<

0.05). Clinical outcomes: the proportion of patients who became HBeAg negative or only presented HBsAg and HBcAb positive was significantly larger in the antiviral groups as compared with the control group (

P

<

0.05)

while the control group showed higher proportion of continuous "double-positive" (

P

<

0.05). In addition

the decrease range of HBeAg-Lg/HBeAb ratio before and after treatment had the greatest value in predicting HBeAg negative conversion.

Conclusion

2

For HBeAg and HBeAb double-positive patients with chronic hepatitis B

interferon treatment shows greater advantage in HBeAg negative conversion. Monitoring the decline of HBeAg-Lg/HBeAb is helpful to predict clinical outcome in the double-positive patients.

关键词

Keywords

references

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