Discussion on Influencing Factors and Treatment Strategy of Negative Conversion in Chronic Hepatitis B Patients with Low-level Viremia
Objective:To analyze the influencing factors of negative conversion in chronic hepatitis B(CHB)patients with low-level viremia,and to discuss the related treatment strategies.Method:A total of 120 CHB patients who received antiviral therapy with first-line nucleos(t)ide analogues(NAs)drugs in Department of Infectious Disease,Pingxiang NO.2 People's Hospital from January 2019 to January 2022 were selected as the study objects.After 36 weeks of treatment with Entecavir or Tenofovir Disoproxil Fumarate,patients who did not turn negative(HBV DNA≥10 IU/mL)were divided into combination group(n=19),change drug group(n=19)and maintenance group(n=20)by random number table method,and they were treated with different treatment plans for 12 weeks.General data of the three groups were collected.The incidence of LLV,HBV DNA,hepatitis B e antigen(HBeAg),hepatitis B surface antigen(HBsAg)and liver stiffness measurement(LSM)of the three groups were compared.At the same time,the clinical baseline data of patients with negative conversion and LLV were compared.Multivariate logistic regression analysis was used to discuss the factors affecting the negative conversion of LLV.Result:After 36 weeks of treatment,62 patients with CHB turned negative,the negative rate was 51.67%,and 58 patients did not turn negative,accounting for 48.33%.Among the three different treatment regimens,the incidence of LLV in maintenance group(85.00%)was the highest,followed by combination group(26.32%)and change drug group(10.53%).There were significant differences in the incidence of LLV,HBeAg,HBsAg and LSM among the three groups(P<0.05).Multivariate logistic regression analysis showed that age,HBsAg,HBeAg and LSM were all factors that affected the negative conversion of LLV(P<0.05).Conclusion:The current clinical first-line NAs drug therapy still needs to further improve the negative conversion rate of LLV patients,and it can be improved by changing the therapeutic drugs or combining with other NAs drugs.The treatment plan for LLV patients still needs further discussion and improvement.
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