Dynamic changes of serum hepatitis B virus DNA and HBsAg in patients with chronic hepatitis B treated with tenofovir disoproxil fumarate for 3 years
10.3969/j.issn.1001-5256.2022.10.006
- VernacularTitle:富马酸替诺福韦酯治疗的慢性乙型肝炎患者3年血清HBV DNA和HBsAg的动态变化
- Author:
Rui LU
1
;
Shuangsuo DANG
1
;
Yixin LIU
1
;
Yikai WANG
1
;
Chenrui LIU
1
;
Yaping LI
1
;
Fengping WU
1
;
Mei LI
1
Author Information
1. Department of Infectious Disease, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
- Publication Type:Original Article_Viral Hepatitis
- Keywords:
Hepatitis B;
Chronic;
Hepatitis B virus;
Hepatitis B Surface Antigens;
Tenofovir
- From:
Journal of Clinical Hepatology
2022;38(10):2224-2229
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the efficacy of tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB) patients receiving antiviral therapy for three years. Methods A total of 157 CHB patients treated with TDF alone for ≥3 years from January 2015 to August 2020 in the Second Affiliated Hospital of Xi'an Jiaotong University were retrospectively studied. The patients were divided into HBeAg-positive and HBeAg-negative groups based on their baseline HBeAg levels. The data of serum HBV DNA and HBsAg levels at baseline, the first, second and third year of treatment were collected to analyze the dynamic changes. The t -test was used to compare continuous variables with normal distributions between two groups, while the Mann-Whitney U test was used to compare continuous variables with non-normal distribution between two groups. Repeated measurement data with non-normal distribution were first transformed into logarithms and the intra- or between-group comparison was performed using repeated measures analysis of variance. The chi-square test or Fisher exact test was used to compare categorical variables between groups. Results HBV DNA clearance rate in HBeAg-positive patients was significantly lower than that in HBeAg-negative patients during the first and second years of TDF treatment (1st year: 65.8% vs 81.0%, χ 2 =4.676, P < 0.05; 2nd year: 87.7% vs 98.8%, Fisher exact test, P < 0.05). When TDF treatment was given for three years, there was no significant difference in HBV DNA clearance rates (97.3% vs 100%, Fisher exact test, P > 0.05). The baseline HBsAg levels in HBeAg-positive and HBeAg-negative patients were 10 633.6 (2 084.8-24 005.7) IU/mL and 1 402.8 (311.0-2 863.5) IU/mL, respectively, and decreased to 1 534.9 (912.7-5 885.9) IU/mL and 677.8 (119.4-1 974.8) IU/mL after 3 years of TDF treatment, with a significant difference between two groups ( F =25.456, P < 0.001). In HBeAg-positive patients, the median decline value of HBsAg level was significantly higher in the first year [1 856.5 (158.4-12 103.1) IU/mL] than in the second year [879.8 (130.5-2 382.5) IU/mL] or the third year [479.9 (95.0-1 662.4) IU/mL] ( F =10.972, P < 0.001), while there was no significant difference in HBeAg-negative patients ( F =0.513, P > 0.05). In addition, after 3 years of TDF treatment, 59.2% of patients achieved HBsAg < 1500 IU/mL, with a HBsAg negative rate of 1.3%. Conclusion After 3 years of TDF treatment, all HBeAg-negative CHB patients can achieve HBV DNA negative conversion; for HBeAg-positive CHB patients, 97.3% of them achieved HBV DNA negative conversion, while 2.7% of them were still HBV DNA detectable. The HBsAg level declined over treatment time, and the decline rate of HBsAg level in HBeAg positive patients showed a trend of "first fast and then slow". After 3 years of TDF treatment, 59.2% of patients achieved HBsAg < 1500 IU/mL.
