Abstract: Objective To investigate the effects of long-term antiviral treatment on the progression of chronic hepatitis B (CHB) patients to cirrhosis or from compensated cirrhosis to decompensated cirrhosis, and investigate the influencing factors of disease progression. Methods Based on the real world research method, a retrospective study was conducted. A total of 92 CHB patients treated in our hospital from October 2006 to October 2021 were included. They were divided into progressive deterioration group (27 cases) and non progressive group (65 cases) according to the condition at initiation and endpoints of antiviral therapy. The end point was the occurrence of cirrhosis (stage 5) or death, and October 2021 as the observation endpoint for patients who did not progress to cirrhosis (stage 5) or death. The clinical data from the initial observation to the end point were collected and analyzed retrospectively. The data were analyzed by SPSS 26. The effects of regular antiviral treatment, alcohol consumption, family history, drug resistance, initial treatment condition and age on the progression of CHB were compared between the 2 groups. Analyze the influencing factors of disease progression in CHB patients. Results (1) There were 70 males (76%) and 22 females (24%) were followed up for 5-16 years with a median follow-up of 9 years. By the end point of observation, 27 cases (29%) had significantly progressed and 83 (71%) cases had not significantly progressed by the observation endpoint. (2) The results of χ² test showed that the incidence rate of disease progression in irregular treatment group (χ²=5.050, P=0.025), drinking group (χ²=3.921, P=0.048), with family history group (χ²=3.940, P=0.047), drug-resistant group (χ²=6.185, P=0.013) was significantly higher than that in the control group (P<0.05); In regular antiviral treatment group, the incidence rate of disease progression in patients with age more than 40 years old (χ²=9.113, P=0.004) and patients with cirrhosis stages 3 and 4 at the start of antiviral therapy (χ²=8.134, P=0.004) was significantly higher than that of the control group (P<0.05); (3) The results of logistic regression analysis showed that age at initiation of antiviral therapy (R=1.147, P<0.01), compliance with treatment (R=5.443, P=0.014), severity of the patient at the initiation of antiviral treatment (R=0.434, P=0.039), drug resistance (R=8.862, P=0.032) was correlated with the patient's disease progression (P<0.05). Conclusion Long-term antiviral treatment can effectively delay the progression of CHB patients.

Key words: Chronic hepatitis B, Cirrhosis, Antiviral therapy, Drug resistance, Compliance