经NAs治疗的CHB患者血清HBV RNA水平及其影响因素

Analysis of serum HBV RNA levels and the Influencing Factors in Patients with Chronic Hepatitis B Treated with NAs

选取2021年1月至2022年6月在湖州市中心医院感染科诊治的慢性乙型肝炎(CHB)患者160例,所有患者经NAs治疗,HBV DNA低于检测下限、发生HBeAg阴转,且HBsAg<1 500 IU/mL;采集患者的血清标本进行HBV RNA检测,同时收集HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc等病毒学指标,以及血生化和血常规;采用单因素及二元Logistic回归分析影响HBV RNA检出率的相关因素,以及HBV RNA与其他指标的相关性.结果发现,在160例CHB患者中,HBV RNA检出率为48.75%;单因素分析结果显示,HBV RNA阳性组的HBsAg和ALT水平比HBV RNA阴性组高,且差异有统计学意义(t=-3.81、-2.493,P<0.05),两组间的性别、乙肝家族史、年龄、治疗时间、抗-HBs、HBeAg、抗-HBe、抗-HBc、天门冬氨酸氨基转移酶(AST)、总胆红素、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、白细胞和血小板,其差异均无统计学意义(P>0.05);二元Logistic回归分析显示,HBsAg和ALT是HBV RNA检出率的独立影响因素(OR=1.001、 1.048,P<0.05);Spearman相关性分析结果显示,HBsAg与HBV RNA存在显著正相关(r=0.248,P<0.001).该研究结果可为CHB患者的抗病毒治疗及停药提供临床指导.

A total of 160 patients with chronic hepatitis B(CHB) were selected from the Department of Infection,Huzhou Central Hospital,from January 2021 to June 2022.After NAs treatment,all patients showed HBV DNA levels below the detection limit,underwent HBeAg negative transformation,and had HBsAg levels of 1 500 IU/mL.Serum samples from the patients were collected for HBV RNA detection,as well as virological indicators including HBsAg,anti-HBs,HBeAg,anti-HBE,anti-HBC,along with blood biochemistry and blood routine were collected.Univariate analysis and binary logistic regression were employed to investigate the factors influencing the detection rate of HBV RNA and to explore the associations between HBV RNA and other indicators.The results showed that the HBV RNA detection rate was determined to be 48.75% among the 160 CHB patients.Univariate analysis indicated that the HBV RNA positive group exhibited higher levels of HBsAg and ALT compared to the HBV RNA negative group,and the these difference were statistically significant(t=-3.81,-2.493,P0.05).Conversely,there were no significant differences observed in terms of gender,family history of hepatitis B,age,treatment duration,anti-HBS,HBeAg,anti-HBE,anti-HBC,aspartate aminotransferase(AST),total bilirubin,alkaline phosphatase(ALP),γ-glutamyl transpeptide(GGT),leukocyte count,and platelet count between the two groups(P0.05).Binary logistic regression analysis further revealed that both HBsAg and ALT were independent factors influencing the detection rate of HBV RNA(OR=1.001,1.048,P0.05).Spearman correlation analysis demonstrated a positive correlation between HBsAg and HBV RNA(r=0.248,P 0.001).This study provides clinical guidance for the administration of antiviral therapy and the cessation of medication in patients with chronic hepatitis B.