慢性乙型肝炎HBeAg阴性患者抗病毒治疗停药后临床观察

目的 探索HBeAg阴性慢性乙型肝炎(chronic hepatitis B,CHB)患者抗病毒药物停用1年后丙氨酸氨基转移酶(ala-nine aminotransferase,ALT)水平变化、病毒学应答特点.方法 收集解放军总医院第五医学中心采用核苷酸类似物(nucleotide ana-logue,NUC)治疗...

Clinical observation of patients with HBeAg negative chronic hepatitis B after withdrawal of antiviral drugs

Objective To observe the patterns of viral responses and changes of alanine aminotransferase (ALT) levels in HBeAg-negative patients one year after withdrawal of antiviral drugs.Methods The clinical data on HBeAg negative chronic hepatitis B patients (CHB) who took nucleotide analogues (NAs) and met the inclusion criteria was collected in our hospital. The clinical characteristics at the time of withdrawal of NAs and one year after treatment were analyzed. Results From January 2017 to July 2020, there were 40 CHB patients who met the inclusion criteria, 19 of whom were HBeAg positive and 21 were HBeAg negative. HBeAg-negative patients were more likely to have their HBV DNA rebounded(P=0.031) and ALT elevated(P=0.017) than HBeAg- positive patients after withdrawal of NAs. HBeAg-negative patients with rebounding HBV DNA after withdrawal of NAs had their HBsAg titers gradually decreased in the 1st month, 3rd month, 6th month, and 12th month. There was statistically significant difference compared with the HBV DNA-negative group. The ALT levels of patients with rebounding HBV DNA gradually increased, but hepatitis B reoccurred only in one patient.Conclusions One year after withdrawal of NAs, the rebound rate of HBV DNA is high and the ALT level is elevated in HBeAg negative patients.For patients with rebounding HBV DNA, HBsAg titers are decreased, which might contribute to the clearance of HBsAg in the long run.