Predictive Analysis On The Efficacy Of Peginterferon In The Treatment Of HBeAg-negative Chronic Hepatitis B Patients Base On HBsAg And HBV DNA

Objective:To investigate the role of hepatitis B virus?HBV?DNA and hepatitis B surface antigen?HBsAg?at baseline and during treatment?week 12,24?to predict the efficacy in hepatitis B e antigen?HBeAg?-negative chronic hepatitis B?CHB?patients receiving peginterferon?-2a.Methods:Treatment-naive HBeAg-negative CHB patients were involved in this prospective study during January 2014 to September 2018 from Shengjing Hospital affiliated to China Medical University.The HBV DNA and HBsAg were quantified at baseline and during treatment?weeks 12,24 and 48?in sera from patients.Virological response defined as HBV DNA can not be detected at week 48,combined response defined as HBV DNA can not be detected and HBsAg<100 IU/ml at week 48.Find a predictor of virological response,combined response at week 48 and calculate the cut-off value for this indicator.The spss21.0 statistical analysis software was used for statistical analysis.In order to incorporate more meaningful indicators into the predictive model,in logistic regression analysis,p<0.1 was considered statistically significant,and the remaining statistical analysis was statistically significant at p<0.05.Result:1.Efficacy analysis:45 patients with HBeAg-negative CHB received PEG-IFN-?-2a treatment,there were 36 respondents at week 48,and the response rate was 80%;19 patients with combined response at week 48,the rate was 52.8%.2.Efficacy predictive analysis:baseline HBV DNA<5.5 log₁₀0 IU/ml?p=0.005?,HBV DNA<3.3 log₁₀0 IU/ml at week 12?p=0.001?,HBV DNA<2.0 log₁₀0 IU/ml at week24?p<0.001?,HBsAg<1400 IU/ml at week 24?p=0.01?can predict virological response at week 48,in which 24-week HBV DNA<2.0 log₁₀0 IU/ml?OR=29.7,p=0.018,PPV=96.9%,NPV=66.7%?was an independent predictor of virological response at week 48.Baseline HBsAg<800 IU/ml?p=0.004?,HBsAg<500 IU/ml at week 12?p<0.001?,HBsAg decline>0.3 log₁₀0 IU/ml at week 12?p=0.048?,HBsAg<300 IU/ml at week 24?p<0.001?,HBsAg decline>0.7 log₁₀0 IU/ml at week 24?p=0.001?can predict combined response at week 48,baseline HBsAg<800IU/ml?PPV=92.1%,NPV=69.7%,OR=29.56,p=0.054?,HBsAg decline>0.7 log₁₀IU/ml at week 24?PPV=83.3%,NPV=77.8%,OR=43.16,p=0.038?was an independent predictor of combined response at week 48.Conclusion:1.For HBeAg-negative CHB patients treated with peg-IFN?-2a,HBV DNA<2.0 log₁₀0 IU/ml at week 24 can be used to predict whether HBV DNA is negative at week 482.For HBeAg-negative CHB patients treated with peg-IFN?-2a,Baseline HBsAg<800 IU/ml,HBsAg decline>0.7 log₁₀0 IU/ml at week 24 can be used to predict whether HBV DNA is negative and HBsAg<100 IU/ml at week 48.