大约 20% 接受治疗的慢性乙型肝炎 (CHB) 患者出现低水平病毒血症 (LLV)，这与持续的低度炎症、纤维化进展和肝细胞癌风险增加有关。我们旨在调查与LLV相关的高危因素。在这项回顾性研究中，纳入2018年1月至2023年1月接受恩替卡韦（ETV）治疗的患者，并分为LLV（HBV DNA 20-2000 IU/mL）队列和根据治疗后 48 周病毒学应答的完全病毒学应答 (CVR) (HBV DNA < 20 IU/mL) 队列。从电子病历中检索治疗基线特征。进行多因素logistic回归分析。共纳入1653例患者，男性患者占73.0%；中位年龄为 44 岁；平均 HBV DNA 水平为 5.9 Log10 IU/ml。其中，472人（28.6%）经历过LLV。多变量分析显示，HBeAg 阳性（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），肝硬化（OR = 1.650，95% CI：1.234-2.207，P = 0.001），LSM ≥ 13.0 kPa（OR =基线时 PLT < 1.644，95% CI：1.203-2.246，p = 0.002）和 PLT < 100×109/L（OR = 1.450，95% CI：1.094-1.922，p = 0.010）与 LLV 的发生有关。高 HBV DNA/HBsAg 定量/LSM、低 PLT、HBeAg 阳性和肝硬化是接受恩替卡韦治疗的患者与 LLV 相关的高危因素。版权所有 © 2024 Li、Chen、Jia、He、Cui、Du、Kang、Feng 、何、金、陈、王、季、刘、吴。

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.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.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.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.Copyright © 2024 Li, Chen, Jia, He, Cui, Du, Kang, Feng, He, Jin, Chen, Wang, Ji, Lau and Wu.