Clinical Study Of HBsAg Become Positive Again In Chronic Hepatitis B Patients After Hepatitis B Surface Antigen Seroconversion With Interferon Treatment

Background Chronic hepatitis B is one of the major infectious diseases and cause agreat harmness to human health.Virological clearance,delayed progression to cirrhosisor liver cancer,and increased survival are the long-term goals of antiviral therapy inchronic hepatitis B patients. Antiviral therapy is the cure among all the therapies withchronic hepatitis B.Recent studies have suggested that peginterferon (PEG-IFN)treatment may be able to patients likely to achieve a sustained response, from thosesome may be HBsAg loss, the ultimate surrogate end-point of CHB therapy.To look forpossible factors that HBsAg become positive again in chronic hepatitis B patients afterhepatitis B surface antigen seroconversion with interferon treatment.Methods Analysis the history characteristics, clinical manifestations, liver function,HBV DNA, HBeAg and side effects of5chronic hepatitis B patients with interferontreatment that exit HBsAg seroconversion and then the HBsAg become positive again in30mouths.Result （1）Baseline conditions：A total of5male patients were included in thisstudy.:aged between17to35years old, HBV DNA>105copies/ml,3HBeAg-positive,four cases of pegylated interferon treatment, treatment time of3to15months.Onepatient’sn mother is hepatitis B carriers. there was no high blood pressure, diabetes,chronic bronchitis and other chronic illnesses in the5patients.(2)serum markers ofHBV:The treatment time of5patients continued3to15months, the HBsAg clearancetime of5patients was3to18months post-treatment. Before or at the same time of3HBeAg-positive patients of the loss of HBeAg, but had not occurred e antigen seroconversion. HBsAb continued6to18months of5cases, the recurrence of HBsAgwas observed after or at the same time. Two patients got both HBsAg and HBsAbpositive in therapy（3）Serum biochemical indicators: After interferon therapy, fivepatients with ALT decreased to varying degrees,2patients was ALT increased againduring treatment or after the end of treatment, less than5ULN.1patients at30months after treatment of HBV DNA of3.36×106copies/ml, and ALT98u/l at thesame time, So he start antiviral therapy: telbivudine0.6g orally once a day, other fourpatients has the HBV DNA tested negative more than a year at the end offollow-up.The situation of side effects: In the early of the use of interferon,4patientshas heating after injection,ibuprofen and other non-steroidal anti-inflammatory drugscan be used completely antipyretic highest body temperature decreased gradually in thesubsequent course of treatment.Duration of fever in the2weeks to2months. patientsduring treatment, white blood cells and neutrophils decreased, but less than qe to thereduction/disable interferon standard.3months after the start of treatment, the patientsappear to hair loss and memory loss, the situation can still be tolerated, not specialtreatment, improved after withdrawal. The patients during treatment of vitiligo, butwithout treatment.Vitiligo occurred in one patient.Conclusion The factors of HBsAg reoccurring after surface antigen seroconversionamong interferon-treated chronic hepatitis B patients may be that: not appear e antigenseroconversion, treatment time is not long enough, and intrahepatic cccDNA is notcleared.