Objective To investigate the influence of baseline HBV DNA level on the clinical outcome of patients with compensated hepatitis B cirrhosis after antiviral therapy. Methods A total of 106 patients with compensated hepatitis B cirrhosis who were treated in Liver Research Center, Beijing Friendship Hospital, Capital Medical University from 2005 to 2015 were enrolled and were given antiviral therapy with nucleos ( t) ide analogues. A three-year prospective follow-up was performed for all patients. According to the baseline HBV DNA level, the patients were divided into HBV DNA < 105 IU/ml group, 105-107 IU/ml group, and > 107 IU/ml group. The three groups were compared in terms of baseline characteristics, outcome of antiviral therapy, and incidence rate of liver-related events ( LREs) . A repeated-measures analysis of variance or the Friedman rank sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to calculate the incidence rates of LREs and plot survival curves, and the log-rank test was used for comparison between groups. Results There were no significant differences between the three groups in age, sex, HBeAg, biochemical parameters, liver stiffness, and Child-Turcotte-Pugh score ( all P >0. 05) . There were significant differences between the three groups in the change trend of HBV DNA level ( F = 8. 35, P < 0. 05) and the degree of such change ( F = 13. 95, P < 0. 05) . At 6 months of treatment, all three groups had a significant reduction in HBV DNA level, and the HBV DNA < 105 IU/ml group and the 105-107 IU/ml group achieved a median HBV DNA level of below the limit of detection, while the HBV DNA > 107 IU/ml group achieved such a level at 12 months of treatment. At 12 and 24 months of treatment, there was no significant difference in HBV DNA clearance rate between the three groups ( χ2= 5. 97 and 6. 84, both P > 0. 05) ; at 36 months of treatment, there was a significant difference in HBV DNA clearance rate between the three groups ( 95. 7% vs 88. 0% vs 77. 8%, χ2= 12. 75, P < 0. 05) . There was no significant difference in the incidence rate of LREs between the three groups ( P > 0. 05) . Conclusion Patients with compensated hepatitis B cirrhosis have a significant reduction in HBV DNA level after antiviral therapy. Although patients with a high level of replication have slow virologic response, baseline HBV DNA level has no influence on the incidence rate of LREs within 3 years of antiviral therapy.
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