HBeAg/HBeAb双阳性慢性乙型肝炎患者不同抗病毒方案疗效及临床转归分析

安选; 刘书宏; 夏莉娜; 巫贵成; 向毅; 胡鹏; 罗欢

doi:10.16016/j.2097-0927.202107114

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HBeAg/HBeAb双阳性慢性乙型肝炎患者不同抗病毒方案疗效及临床转归分析

临床医学 | 更新时间：2026-01-09

- HBeAg/HBeAb双阳性慢性乙型肝炎患者不同抗病毒方案疗效及临床转归分析
- Efficacy and clinical outcomes of different antiviral regimens in HBeAg/HBeAb double-positive patients with chronic hepatitis B
- 陆军军医大学学报 2022年44卷第2期页码：162-167
- 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：
  
  [刘书宏, E-mail: 57485971@qq.com LIU Shuhong, E-mail: 57485971@qq.com
- 基金信息：
  
  重庆市卫计委医学科研项目(20142136)
- DOI：10.16016/j.2097-0927.202107114
  中图分类号： R512.62;R969.4;R978.7
- 收稿：2021-07-18，
  
  修回：2021-11-03，
  
  纸质出版：2022-01-30
- 稿件说明：
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安选, 刘书宏, 夏莉娜, 等. HBeAg/HBeAb双阳性慢性乙型肝炎患者不同抗病毒方案疗效及临床转归分析[J]. 陆军军医大学学报, 2022,44(2):162-167.

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.
安选, 刘书宏, 夏莉娜, 等. HBeAg/HBeAb双阳性慢性乙型肝炎患者不同抗病毒方案疗效及临床转归分析[J]. 陆军军医大学学报, 2022,44(2):162-167. DOI： 10.16016/j.2097-0927.202107114.

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

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

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

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(

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(

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(

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(

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

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

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

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 (

=52)

interferon treatment group (

=49)

and control group (without antiviral treatment

=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

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

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 (

0.05)

while the decline of HBeAg and HBeAb levels

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

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 (

0.05)

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

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

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

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