抗病毒治疗停药后乙型肝炎复发与血清HBV DNA水平的相关性分析

Correlation analysis of hepatitis B recurrence and serum HBV DNA levels after antiviral therapy

目的探讨乙型肝炎患者在接受抗病毒治疗停药后,乙型肝炎的复发情况与患者血清的HBV DNA水平的相关性。方法回顾性分析我院150例接受抗病毒治疗后达到停药标准的慢性乙型肝炎患者,其中乙型肝炎e抗原(HBe Ag)阳性90例,HBeAg阴性60例,其中接受阿德福韦酯治疗51例(ADV组),接受恩替卡韦治疗36例(ETV组),接受拉米夫定治疗63例(LAM组),收集患者治疗前及治疗1个月后的血清HBV DNA水平,比较停药48周后各组HBV DNA转阳情况,对比患者治疗停药后复发情况。结果 LAM组、ADV组和ETV组患者在停药48周时血清HBV DNA转阳率比较差异无统计学意义。当患者HBe Ag为阳性和阴性时,治疗前的HBV DNA水平越高,停药后复发率也越高。治疗1个月后,HBV DNA水平越低,停药后复发率也越低。结论慢性乙型肝炎患者的复发率与服用抗病毒药物治疗之前的血清HBV DNA水平、治疗1个月后的HBV DNA水平和血清中HBV DNA的水平下降幅度存在着相关性。

Objective To investigate the correlation between the recurrence of hepatitis B and the serum levels of HBV DNA in patients with hepatitis B after antiviral therapy. Methods 150 patients with chronic hepatitis B who reached the standard of discontinuation after antiviral treatment were retrospectively analyzed. Among them, hepatitis B e antigen （HBeAg） was positive in 90 cases, HBeAg negative in 60 cases. Among them, 51 patients were treated with adefovir dipivoxil （group ADV）, 36 patients received entecavir treatment （group ETV）, and 63 patients received lamivudine treatment （group LAM）. The serum levels of HBV DNA were collected before and 1 months after treatment, and the HBV DNA seroeonversion in each group after 48 weeks were compared, and the recurrence after treatment was compared. Results There was no significant difference in serum HBV DNA seroconversion rates between group LAM, group ADV and group ETV at 48 weeks after withdrawal. When the patient was HBeAg positive and negative, the higher the level of HBV DNA before treatment, the higher the recurrence rate after discontinuation. After 1 months of treatment, the lower the level of HBV DNA, the lower the recurrence rate after discontinuation of the drug. Conclusion The recurrence rate of patients with chronic hepatitis B is related to the level of serum HBV DNA before taking antiviral drugs, the level of HBV DNA after 1 months of treatment, and the decline range of serum HBV DNA levels.