Study On The HBeAg Seroconversion Influenced Factors Of Telbivudine Therapy In Chronic Hepatitis B

Objective: To investigate the influence factors of telbivudine(Ld T)-induced HBe Ag seroconversion in chronic hepatitis B(CHB)patients.Methods: A total of 77 CHB patients,who were treated with Ld T in the Clinic of Infectious Diseases of the First Hospital Affiliated to Guangxi Medical University from September 2011 to August 2015,were retrospectively analyzed in this study.At the end of the follow-up period,those who presented HBe Ag seroconversion were assigned to the seroconversion group,while the others were assigned to the non-seroconversion group.The clinical characteristic of 77 patients were collected.And logistic regression analysis were done to investigate the influence factors of HBe Ag seroconversion.Results: 1.There was no significant difference in sex and gender between the seroconversion group and the non-seroconversion group(p >0.05).2.Baseline globulin level in the seroconversion group was lower than that in the non-seroconversion group,which was significant difference(p<0.05).There was no significant difference in baseline levels of HBV DNA,total bilirubin,direct bilirubin,indirect bilirubin,albumin,aspartic aminotransferase,alanine transaminase,gamma-glutamyltransferase,total bile acid,alkaline phosphatase,prealbumin,cholinesterase,HBe Ag and HBc Ab between the two groups(p>0.05).3.In the 12 months treatment,there was no significant difference in the rate of HBV DNA negative between the two groups(p>0.05).4.Endpoint globulin level of the seroconversion group was lower than that in the non-seroconversion group,which was significant difference(p<0.05).5.Mulvariate logistic regression analysis showed that the baseline of globin was the influence factor of HBe Ag seroconversion in Ld T treated CHB patients.Both were negatively correlated(p<0.05).There was no significant correlation between baseline HBV DNA and baseline ALT and HBe Ag seroconversion.6.Baseline globulin of the seroconversion group was mostly less than 30 g/l.Baseline globulin of the non-seroconversion group was mostly distributed at 30-40 g/l.7.ROC curve analysis of baseline globulin was used as diagnostic indicators of Ld T-induced HBe Ag seroconversion in CHB patients.The area under ROC curve was 0.64 and the cut off value was28.25g/l.The sensitivity and specificity value were 50.00%,79.10%respectively.Conclusion: Baseline globin may be one of the influence factors of HBe Ag seroconversion in Ld T treated CHB patients.