Risk factors for hypoviremia in chronic hepatitis B patients undergoing antiviral therapy:A comprehensive analysis
Objective To identify risk factors associated with hypoviremia in chronic hepatitis B patients receiving antiviral therapy.Methods A total of 108 chronic hepatitis B patients receiving antiviral treatment at our hospital were selected for this study.Based on high-sensitivity HBV DNA quantitative testing results,they were catergorized into a hypoviremia group(60 cases)and a complete virological response group(48 cases).Clinical data from both groups were collected and compared,and logistic regression analysis was employed to identify risk factors associated with hypoviremia.Results The rate of second-line initial treatment in the hypoviremia group was significantly higher than that in the complete virological response group(18.75％vs 2.63％,P＜0.05),while the medication adherence rate was significantly lower(71.88％vs 91.67％,P＜0.05).No statistically significant differences were observed bettwen the two groups in AST[(30.22±8.34)U/L vs(28.30±8.23)U/L],ALT[(25.35±3.49)U/L vs(27.03±4.63)U/L],TBil[(14.35±3.71)μmol/L vs(13.74±2.87)μmol/L],or HBcAb levels[(94.66±23.82)S/CO vs(95.14±26.73)S/CO](P＞0.05).However,the hypoviremia group exhibted significantly higher rates of HBeAg positivity(59.38％vs 10.53％),HBsAg levels[(3.24±0.36)IgIU/ml vs(2.87±0.32)IgIU/ml],and baseline HBV DNA levels[(7.40±1.33)vs(5.78±1.42)]compared to the complete virological response group(P＜0.05).The factors of second-line initial treatment,HBeAg positivity,HBsAg levels,and baseline HBV DNA levels were negatively correlated with complete virological response(r=-0.411,-0.352,-0.413,-0.492,P＜0.05),while good medication adherence is positively correlated(r=0.425,P＜0.05).Logistic regression analysis identified HBeAg positivity,HBsAg levels,and baseline HBV DNA levels as significant risk factors for hypoviremia(OR=2.809,1.861,1.311,P＜0.05),whereas good medication adherence emerged as a protective factor(OR=0.810,P＜0.05).Conclusion Positive HBeAg,elevated HBV DNA load,and high HBsAg levels prior to antiviral treatment are significant risk factors for the develpment of hypoviremia in chronic hepatitis B patients.Ensuring good medication adherence is crucial for achieving virological responses.Early,targeted interventions should be implemented in clinical practice for CHB patients identified with these high-risk factors.
万方数据
维普
