Influencing factors of low-level viremia in patients with chronic hepatitis B treated with Entecavir

Abstract

Abstract: Objective To investigate the current status of low-level viremia(LLV)in Entecavir(ETV)-treated chronic hepatitis B(CHB)patients and explore the related factors of LLV. Methods The study was conducted from April 2021 to December 2021. CHB patients who were treated with ETV over one year in The First Affiliated Hospital of Shantou University Medical College and experienced LLV(HBV DNA <100 IU/mL)were enrolled for high-sensitivity HBV DNA detection(the lower limit of detection: 10 IU/mL). According to the test results, they were divided into virological response(VR)group and LLV group. The demographic data and laboratory findings of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the related factors of LLV in CHB patients treated with long-term ETV. Results A total of 260 CHB patients were included, 40 in the LLV group and 220 in the VR group. The incidence of LLV was 12.8% (25/195)in males, lower than 23.1% (15/65)in females (χ²=3.939, P=0.047); was 12.6% (30/239)in patients with good compliance, lower than 47.6% (10/21)in patients with poor compliance (χ²=15.640, P<0.001); was 8.8% (8/91)in cirrhotic patients, lower than 18.9% (32/169)in non-cirrhotic patients (χ²=4.675, P=0.031); was 30.0% (27/90)in HBeAg-positive patients, higher than 7.6% (13/170)in HBeAg-negative patients (χ²=22.587, P<0.001). The baseline virus load of the LLV group was higher when compared with the VR group(7.0 log10IU/mL vs. 5.6 log10IU/mL, Z=-4.458, P<0.001). Multivariate logistic regression analysis showed that poor medication compliance(OR=2.927, 95%CI: 1.078～7.949, P=0.035), positive HBeAg (OR=2.473, 95%CI: 1.064-5.747, P=0.035)and high HBV DNA load (OR=1.441, 95%CI: 1.068-1.943, P=0.017)before treatment were independent risk factors for LLV in CHB patients treated with ETV. Conclusion Even after long-term entecavir treatment, 15.4% (40/260)of CHB patients with HBV DNA < 100 IU/mL still had LLV. In clinical practice, poor compliance, positive HBeAg and high viral load are risk factors for LLV.

Key words: Chronic hepatitis B, Entecavir, Low-level viremia, Risk factors

HUANG Yong-xu, CHEN Chao, BAO Zi-hong, ZHOU Xiao-hui. Influencing factors of low-level viremia in patients with chronic hepatitis B treated with Entecavir[J]. Chinese Hepatolgy, 2023, 28(3): 320-324.

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