Clinical efficacy analysis of nucleoside analogues in the treatment of HBeAg positive patients with high viral load chronic hepatitis B

Xiuli Ding; Huafa Yin; Xiaoling Cui

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Clinical efficacy analysis of nucleoside analogues in the treatment of HBeAg positive patients with high viral load chronic hepatitis B

Author: Xiuli Ding ¹ ; Huafa Yin ² ; Xiaoling Cui ³
Author Information

1. Dept of Infectious Diseases , The First Afiliated Hospital of Anhui Medical University , Hefei 230022; Dept of Infectious Diseases , Second Afiliated Hospital of Bengbu Medical University , Bengbu 233000
2. Dept of Infectious Diseases , The First Afiliated Hospital of Anhui Medical University , Hefei 230022
3. Dept of Infectious Diseases , Tongling People ′s Hospital , Tongling 244000
Publication Type:Journal Article
Keywords: chronic hepatitis B; high viral load; nucleoside(acid) drugs; monotherapy; combination therapy; antiviral therapy
From: Acta Universitatis Medicinalis Anhui 2025;60(6):1134-1139, 1148
CountryChina
Language:Chinese
Abstract: Objective :To compare the antiviral efficacy and renal safety of nucleoside analogs(NAs) monotherapy versus combination therapy in hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB) patients with high viral load.
Methods : This study enrolled a total of 353 treatment-naïve HBeAg-positive chronic hepatitis B (CHB) patients with high viral load , the treatment regimen was divided into 5 groups , consisting of 4 monotherapy groups and 1 combination therapy group as follows : 88 cases in the Entecavir (ETV) group , 135 cases in the Teno- fovir Disoproxil Fumarate (TDF) group , 34 cases in the Tenofovir Alafenamide Fumarate (TAF) group , 25 cases in the Tenofovir Amibufenamide (TMF) group , and 71 cases in the ETV combined with TDF (ETV + TDF) group . A retrospective cohort study design was adopted to analyze HBV DNA levels , serological indicators ( HBsAg and HBeAg levels) , renal function indicators ( serum Scr levels , eGFR) at 24 and 48 weeks of treatment across various groups , as well as the HBsAg clearance rates , HBeAg seroconversion rates and HBV DNA suppression rates (HBV DNA < 20 IU/ml) at 48 weeks across the groups . Multivariate logistic regression analysis was conducted to identify the influencing factors for HBV DNA suppression .
Results :At 24 weeks , the HBV DNA level in the ETV + TDF selected . Key miRNAs included hsa-let-7b-5p , hsa-let-7c-5p , hsa-let-7b-3p _ 1ss22CT , and hsa-miR-199b-5p , with BACH1 and IFNAR1 identified as their shared target genes . GO analysis revealed that the enriched target genes were primarily involved in protein binding , metal ion binding , transferase activity , DNA binding , transcriptional regulation by RNA polymerase Ⅱ , and nucleotide binding. KEGG pathway analysis indicated that the target genes were mainly associated with metabolic pathways , cancer-related pathways , the PI3K-Akt signaling pathway , and the Rap1 signaling pathway .
Conclusion :Differential expression of miRNAs in amniotic fluid exosomes was ob- served between DS fetuses and those with normal karyotypes . Combined analysis with placental miRNAs revealed hsa-miR-199b-5p as a common differentially expressed miRNA in both DS amniotic fluid and placenta. It is hypoth- esized that BACH1 and IFNAR1 , shared target genes of hsa-miR-199b-5p , hsa-let-7b-5p , hsa-let-7c-5p , and hsa- let-7b-3p_1ss22CT , may play a role in the pathogenesis of DS .