昆明医科大学学报2025，Vol.46Issue(1)：51-59,9.DOI:10.12259/j.issn.2095-610X.S20250107
不确定期慢性乙型肝炎病毒感染患者抗病毒疗效及安全性分析
Analysis of Antiviral Efficacy and Safety in Patients with Chronic Hepatitis B in Indeterminate Phase
摘要
Abstract
Objective To analysis the efficacy and safety of antiviral therapy in patients with chronic hepatitis B virus in indeterminate phase based on the new guidelines(2022 Edition of the Guidelines for the Prevention and Treatment of Chronic Hepatitis B).Methods A total of 170 patients with newly diagnosed HBV infection who visited the Third People's Hospital of Kunming from August 1,2020,to July 31,2024,were selected as study subjects.The clinical indicators of patients with normal ALT in the indeterminate phase were analyzed after 12 weeks,24 weeks,and 48 weeks of antiviral treatment,as well as those who did not receive antiviral treatment for 48 weeks.Results(1)Among the 170 patients with normal ALT during the indeterminate phase of HBV infection,the treatment group consisted of 125 patients(36 HBeAg positive and 89 HBeAg negative),while the untreated group had 45 patients.In the treatment group,the HBV-DNA load and HBsAg titer decreased significantly after 48 weeks compared to before treatment,with statistically significant differences(both P<0.05).In the untreated group,the HBV-DNA load showed an upward trend,and the HBsAg titer slightly decreased,with statistically significant differences(both P<0.05).(2)The CVR rate in the treatment group after 48 weeks was 66.67%(24/36)for HBeAg positive patients and 95.51%(85/89)for HBeAg negative patients,with a statistically significant difference(P<0.05).(3)The treatment group showed a significant decrease in GGT and AFP after 48 weeks compared to before treatment,while the untreated group saw an increase in ALT,GGT,and AFP,with statistically significant differences(all P<0.05).(4)The fibrosis indicators APRI,FIB-4,and LSM in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).(5)The safety indicators CREA,blood calcium,and blood phosphorus in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).Conclusion Expanding the antiviral treatment indications according to the new guidelines for patients with normal ALT in the indeterminate phase of HBV infection demonstrates good efficacy in controlling HBV-DNA,improving CVR rates,and enhancing fibrosis indicators,while also showing favorable renal safety.However,there may be a risk of osteoporosis due to calcium and phosphorus metabolism disorders,necessitating enhanced monitoring and prevention.关键词
慢性乙型病毒性肝炎/丙氨酸氨基转移酶/不确定期/抗病毒治疗Key words
Chronic hepatitis B virus infection/Alanine aminotransferase/Indeterminate phase/Antiviral treatment分类
医药卫生引用本文复制引用
艾骞,赵智蓉,吴月,李海雯,李生浩,杨永锐..不确定期慢性乙型肝炎病毒感染患者抗病毒疗效及安全性分析[J].昆明医科大学学报,2025,46(1):51-59,9.基金项目
国家自然科学基金(822604408) （822604408）
昆明市科技计划(2023-1-NS-033) （2023-1-NS-033）
