关键词: 核苷(酸)类药物;HBsAg定量水平;预测价值

Abstract: Objective To investigate the dynamic changes of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) DNA in HBeAg-positive chronic hepatitis B (CHB) patients with long-term treatment of nucleos(t)ide analogues, and to analyze their correlations with HBeAg seroconversion.Methods Clinical data of 439 HBeAg-positive CHB patients with 4-year follow-up was retrospectively analyzed. Results At baseline, HBsAg was positively correlated with HBeAg and HBV DNA, and HBeAg was weakly positively correlated with HBV DNA in HBeAg-positive CHB patients. After 4-year antiviral therapy, levels of HBsAg, HBeAg and HBV DNA were significantly decreased. Higher HBsAg decline rate in the first 6 months and lower levels of HBsAg and HBeAg at baseline showed higher possibility of HBeAg serum response (SR) rate. Among the HBeAg-positive CHB patients, there were 31.44% acheiving HBeAg SR, including 28.65% with entecavir treatment, 50.34% with telbivudine, 48.39% with telbivudine + adefovir, 9.09% with entecavir + adefovir and 10.13% with lamivudine + adefovir.Conclusion Patients with higher HBsAg decline rate in the initial 6 months of antiviral therapy, as well as lower levels of HBsAg and HBeAg at baseline, might have the higher possibility to acheive HBeAg SR.

Key words: Nucleos(t)ide , Quantitative hepatitis B surface antigen levels, Predictive value