抗病毒治疗对低病毒载量的乙肝ACLF患者生存率的影响

目的 探讨抗病毒治疗对低病毒载量的乙型肝炎相关慢加急性肝衰竭（ACLF）患者转归的影响.方法 352例乙型肝炎相关ACLF患者,其中低病毒载量组175例、高病毒载量组177例,各组分为护肝治疗（对照）组及抗病毒治疗组,比较两组患者临床特征、生存率及抗病毒治疗短期疗效差异.结果 观察24周,抗病毒治疗组的乙型肝炎相关ACLF患者总体生存率高于护肝治疗者（P=0.010）,低病毒载量组中抗病毒治疗组的生存率高于护肝治疗组（P=0.001）,高病毒载量组中抗病毒治疗组与护肝治疗组生存率差异无统计学意义（P=0.856）,抗病毒治疗组中低病毒载量组与高病毒载量组的生存率差异无统计学意义（P=0.755）.结论 抗病毒治疗可提高低病毒复制的乙型肝炎相关ACLF患者的生存率.

Efficacy of antiviral treatment on patients with acute-on-chronic hepatitis B liver failure with low viral load

Objective To investigate the efficacy of antiviral treatment on patients with acute-onchronic hepatitis B liver failure with low viral load. Methods 352 patients with acute-on-chronic hepatitis B liver failure including 175 cases of low HBV viral load and 177 cases of high HBV viral load were enrolled into this study. The patients were divided into the antiviral group which received antiviral therapy (Lamivudine, Entecavir or Telbivudine) plus routine supportive therapy and the control group which supportive therapy only. The clinical features and the 24-week short-term efficacy of antiviral therapy were assessed. Results At week 24,total survival rate in antiviral group was higher than that in control group (P = 0. 010 ). The survival rate of patients with low viral load in the antiviral group was higher than that in the control group ( P = 0. 001 ). But there was no significant difference between the antiviral group and the control group with high viral load (P = 0. 856). But in the antiviral group, there was no significant difference in survival rate between the patients with high HBV viral load and those with low viral load ( P = 0. 755 ). Conclusions Antiviral therapy can significantly improve survival rate of patients of acute-on-chronic hepatitis B liver failure with low viral load.