HBeAg阴性HBV DNA阳性慢性HBV感染者治疗的预测分析

A predictive analysis for the treatment necessity of HBeAg negative,HBV DNA positive patients with chronic hepatitis B viral infection

目的研究HBeAg阴性乙肝病毒(hepatitis B virus,HBV)DNA阳性慢性乙肝病毒感染者达到治疗时间的预测指标。方法将入组的108例患者,根据肝脏病理结果分为治疗组和随访组,将年龄、性别、感染家族史、HBsAg定量水平、HBV DNA载量纳入单因素分析,有统计学意义的变量进行Logistic多变量回归分析,有影响的独立危险因素应用受试者操作特征曲线定义截断值。结果108例HBeAg阴性HBV DNA阳性慢性乙肝病毒感染者达到治疗标准的有29例,占比26.7%。年龄、感染家族史是需要治疗的独立危险因素。年龄的截断值为35.5岁。结论HBeAg阴性HBV DNA阳性慢性乙肝病毒感染者中也有需要治疗的,年龄大、有感染家族史是需要治疗的独立预测危险因素,年龄大于35.5岁时,需要抗病毒治疗,而HBsAg定量水平、HBV DNA载量不是独立预测危险因素。

Objective To study on the predictive index for the treatment necessity of HBeAg negative HBV DNA positive patients with chronic hepatitis B(CHB)viral infection.Methods 108 patients were divided into treatment group and follow-up group according to their liver pathology.Patients in the treatment group had significant hepatic inflammation(>grade 2)or fibrosis(>grade 2)under pathological examination,and patients in the follow-up group had less severe histological changes.Age,gender,family history of HBV infection,quantitative level of HBsAg,and HBV DNA load were included in single factor analysis for the treatment necessity.Logistic multivariate regression analysis was carried out on the statistically significant variables.The cut-off values of the independent risk factors were defined by receiver operating characteristic(ROC).Results Among the 108 cases of HBeAg negative HBV DNA positive patients with chronic HBV infection,29(26.7%)reached the criteria of treatment.Age and family history of HBV infection are independent risk factors for the treatment necessity.The cutoff value of risk age was 35.5 years old.Conclusion HBeAg negative HBV DNA positive patients with chronic HBV infection may also require treatment,with age older than 35.5 years and family history of HBV infection as independent predictors for the necessity.