Abstract: Objective To investigate the efficacy of nucles(t)ide analogues in the treatment of chronic hepatitis B patients with positive serum HBeAg and to assess the significance of detecting serum HBV RNA. Methods A total of 58 patients with HBeAg positive chronic hepatitis B were treated with nucles(t)ide analogues for 24 weeks between March 2018 and January 2021. The study compared the clinical characteristics before and after treatment, and analyzed the predictive value of serum ALT and HBV RNA in rapid virological response. Results The comparison of clinical characteristics before and after treatment revealed that the levels of total red bilirubin, ALT, HBV DNA and HBV RNA after treatment were (0.2±0.1) mg/dL, (121.5±59.0) U/L, 0.8 (0.5, 0.3)log₁₀copies/mL and 1.4 (1.1, 1.7)log₁₀copies/mL. These values were significantly lower than those of the before treatment group [(0.8±0.3) mg/dL, (168.3 ± 134.6) U/L, 8.4 (5.1, 10.6)log₁₀copies/mL and 7.2 (5.0, 9.9)log₁₀copies/mL (P<0.05)]. The negative rates of serum HBV DNA and HBV RNA were 94.8% and 70.7%, significantly higher than those before treatment [0.0% and 0.0% (P<0.05)]. Serum ALT and HBV RNA were found to have predictive value for rapid virological response, with the AUC values of 0.629 and 0.831 respectively. The best cutoff values for predicting rapid virological response were found to be ≥ 142 for ALT and 1.9 for HBV RNA, with respective sensitivity of 59.0 % and 82.0 %, and specificities of 72.1 % and 80.0 %. The positive predictive values for ALT and HBV RNA were 74.8 % and 86.6 %, while the negative predictive values were 58.2 % and 83.0 %, respectively. Conclusion Nucles(t)ide analogues demonstrate strong efficacy in patients with chronic hepatitis B with positive serum HBeAg. Additionally, serum HBV RNA is identified as a reliable predictor of rapid virological response.

Key words: Chronic hepatitis B, HBeAg, Nucles(t)ide analogues, Curative effect