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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1413589

Risk factors related to low-level viraemia in chronic hepatitis B patients receiving entecavir treatment

Provisionally accepted
Zhong-Bin Li Zhong-Bin Li 1Dan-Dan Chen Dan-Dan Chen 2Yun-Fei Jia Yun-Fei Jia 3Qing-juan He Qing-juan He 4Li Cui Li Cui 1Feng-Xia Du Feng-Xia Du 5Yao-Jie Kang Yao-Jie Kang 1Xin Feng Xin Feng 6Mengwen He Mengwen He 7Xue-Yuan Jin Xue-Yuan Jin 1Jing Chen Jing Chen 8Yudong Wang Yudong Wang 8Dong Ji Dong Ji 1,7*George Lau George Lau 8Shu-Gao Wu Shu-Gao Wu 6
  • 1 Fifth Medical Center of the PLA General Hospital, Beijing, Beijing Municipality, China
  • 2 Jingzhou Second People's Hospital, Jingzhou, China
  • 3 Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou, Henan Province, China
  • 4 Qingdao Eighth People's Hospital, Qingdao, Shandong Province, China
  • 5 Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
  • 6 Beijing Information Science and Technology University, Beijing, Beijing, China
  • 7 302 Clinical Medical College, Peking University, Beijing, China
  • 8 Humanity and Health Medical Group, Hong Kong, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

    Background About 20% of on-treatment patients with chronic hepatitis B (CHB) experienced low-level viraemia (LLV), which is associated with persistent low-grade inflammation, fibrosis progression, and increased risk of hepatocellular carcinoma. We aimed to investigate the high-risk factors related to LLV. Methods In this retrospective study, patients receiving entecavir (ETV) treatment from January 2018 to January 2023 were enrolled, and were divided into a LLV (HBV DNA 20-2000 IU/mL) cohort and a complete virological response (CVR) (HBV DNA < 20 IU/mL) cohort according to the virological response at week 48 posttreatment. Treatment baseline characteristics were retrieved from electronic medical records. Multivariate logistic regression was performed. Results Totally, 1653 patients were enrolled, male patients accounted for 73.0%; the median age was 44 years; the mean HBV DNA level was 5.9 Log10 IU/ml. Among them, 472 (28.6%) experienced LLV. Multivariate analysis showed that HBeAg positivity (OR = 2.650, 95% CI: 2.000-3.511, p < 0.001), HBV DNA ≥ 6.0 Log10 IU/mL (OR = 1.370, 95% CI: 1.054-1.780, p = 0.019), qHBsAg ≥ 9000 IU/mL (OR = 4.472, 95% CI: 3.410-5.866, p < 0.001), cirrhosis (OR = 1.650, 95% CI: 1.234-2.207, P = 0.001), LSM ≥ 13.0 kPa (OR = 1.644, 95% CI: 1.203-2.246, p = 0.002), and PLT < 100×109/L (OR = 1.450, 95% CI: 1.094-1.922, p = 0.010) at baseline were related to the development of LLV. Conclusions High HBV DNA/HBsAg quantification/LSM, low PLT, HBeAg positivity, and liver cirrhosis were high-risk factors associated with LLV in patients receiving entecavir treatment.

    Keywords: CHB, chronic hepatitis B, HBV, hepatitis B virus, CVR, complete virological response, LLV, low-level viremia, HCC, hepatocellular carcinoma, NAs, nucleos(t)ide analogs, ETV, entecavir, TAF, tenofovir alafenamide fumarate

    Received: 07 Apr 2024; Accepted: 08 Jul 2024.

    Copyright: © 2024 Li, Chen, Jia, He, Cui, Du, Kang, Feng, He, Jin, Chen, Wang, Ji, Lau and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dong Ji, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China

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