Clinical efficacy of entecavir in HBeAg-negative chronic hepatitis B with compensated cirrhosis

Objective To investigate the clinical efficacy of 96- week entecavir( ETV) treatment for HBe Ag- negative chronic hepatitis B patients with compensated cirrhosis,as well as its effect on patients with different HBV DNA loads. Methods A total of 118 chronic hepatitis B patients with compensated cirrhosis who visited Xiangyang Hospital of Traditional Chinese Medicine from January 2009 to June 2013 were enrolled and all had Child- Pugh class A cirrhosis. According to HBV DNA load,these patients were divided into high- load group( group A,HBV DNA≥105copies / ml) and low- load group( group B,HBV DNA < 105 copies / ml). All the patients were treated with ETV 0. 5 mg / d for 96 weeks. Child- Pugh score was used to evaluate liver function before and after treatment,and the changes in alanine aminotransferase( ALT),albumin( Alb),and total bilirubin( TBil) after treatment were observed. Hyaluronic acid( HA),α2- macroglobulin,and liver stiffness measurement( LSM) were used to evaluate liver fibrosis. The t- test was used for comparison between groups,and a repeated- measures analysis of variance was used for comparison within one group and between groups at different time points. Chisquare test was applied for comparison of categorical data between the two groups. Results The two groups showed significant reductions in ALT,Alb,and TBil at weeks12 and 24 of treatment( all P < 0. 05),and the ALT normalization rate and HBV DNA clearance rate at weeks 24 and 48 of treatment showed significantly differences between the two groups( χ2= 9. 241,6. 428,11. 134,5. 139,all P < 0. 05). Both groups showed significant reductions in HA,α2- macroglobulin,and LSM after treatment( t = 2. 648,1. 921,4. 018,3. 166,2. 136,3. 461,all P < 0. 05). The incidence rates of complications such as variceal bleeding,ascites,and hepatocellular carcinoma showed no significant differences between the two groups( all P > 0.05). Conclusion In HBe Ag- negative chronic hepatitis B patients with compensated cirrhosis,ETV can significantly improve liver function,slow down the process of liver fibrosis and cirrhosis,and effectively reduce long- term complications.