Treatment Efficacy And Related Factors Of Nucleos(t)ide Analogues In Patients With CHB And Related Liver Fibrosis

Objective: To investigate virological,biochemical and histological changes in nucleoside(t)ide analogues(NAs)-treated patients with chronic hepatitis B(CHB)or CHB-related fibrosis,and explore their relationships with incidence of cirrhosis and hepatocellular carcinoma(HCC).Methods: 1.A total of 6 688 NAs-treated CHB patients diagnosed in our hospital were included.Changes in serological,biochemical and virological parameters during antiviral treatment were recorded and the relationships with cirrhosis and HCC incidence were explored.2.Thirty-four CHB patients with advanced liver fibrosis were enrolled in the study.Liver biopsy was conducted at baseline and year 5 in these patients.Blood rutine,biochemical and virological were regually examined every 3 months.Histological changes after long-term antiviral therapy were also analyzed.Results: 1.Among the antiviral CHB patients,cirrhosis was the independent risk factor for HCC.Incidence of cirrhosis and HCC was decreased in patients with hepatitis B surface antigen(HBs Ag)loss.Biological breakthrough,virological breakthrough and hepatitis B e antigen(HBe Ag)loss had no obvious effect on disease progression.Good compliance would lower the risk of developing cirrhosis and HCC in CHB patients.2.Alanine transaminase normalization and HBV DNA undetectable were achieved in all CHB-related fibrosis patients after 5-year NAs therapy.Six patients had HBe Ag clearance,but none with HBe Ag seroconversion and none achieved HBs Ag loss.Among the 16 patients with paired liver biopsies,one patients achieved complete reversion of fibrosis and 75%(12/16)patients achieved histological improvement.Conclusion: During antiviral treatment with NAs,improving compliance of patients could help decrease the incidence of cirrhosis and HCC.Cirrhosis was the independent risk factor for HCC and long-term antiviral treatment could achieve histological improvement.