title: [HBsAg clearance rate in patients with HBeAg-positive chronic hepatitis B: a comparative effect analysis based on the real world].
abstract: OBJECTIVE
  To investigate HBsAg clearance rate in previously untreated patients with HBeAg-positive chronic hepatitis B (CHB) treated with nucleos(t)ides and interferons and its influencing factors based on the clinical diagnosis and treatment dat.
  
  
  METHODS
  A retrospective cohort study was conducted in 1 767 previously untreated HBeAg-positive CHB patients who visited Beijing You'an Hospital from February 14, 2008 to December 31, 2012. HBsAg clearance rates were calculated for patients with different characteristics, and the Cox regression model was used to investigate the influencing factors for HBsAg clearance.
  
  
  RESULTS
  The overall annual HBsAg clearance rate was 0.46% in 1767 patients, and in the patients treated with adefovir, entecavir, telbivudine, and common interferon, the annual HBsAg clearance rate was 0.52%, 0.47%, 0.45%, and 1.18%, respectively. No patients in the lamivudine and pegylated interferon-α groups experienced HBsAg clearance, which might be due to the small sample size. The univariate analysis showed that HBsAg clearance rate was associated with the patient's age when he/she visited the hospital and baseline HBsAg titer level. After adjustment for other factors, the patients treated with common interferon had a significantly higher possibility of HBsAg clearance than those treated with entecavir (HR = 8.33, 95% CI: 1.19-58.50, P = 0.0329), but the possibility of HBsAg clearance showed no significant difference between patients treated with other nucleos(t)ides and entecavir. The patients aged≥50 years had a probability of HBsAg clearance 4.92 times that of those aged < 50 years (HR = 4.92, 95% CI: 1.38-17.50, P = 0.0139) and the patients with baseline HBsAg titer level < 3 log10 IU/ml had a probability of HBsAg clearance 22.77 times higher than that of those with baseline HBsAg titer level≥3 log10 IU/ml (HR = 23.77, 95% CI: 6.17-91.51, P < 0.0001).
  
  
  CONCLUSIONS
  The previously untreated CHB patients achieve a low annual HBsAg clearance rate under current antiviral therapeutic regimens, especially nucleos(t)ides. Baseline HBsAg titer level is closely associated with HBsAg clearance.
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China.
authors.forename: K L
authors.initials: KL
authors.lastname: Cheng
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: M M
authors.initials: MM
authors.lastname: Xu
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Qiu
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: L K
authors.initials: LK
authors.lastname: Yang
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: X W
authors.initials: XW
authors.lastname: Duan
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Beijing You'an Hospital of Capital Medical University, Beijing 100069, China.
authors.forename: Z P
authors.initials: ZP
authors.lastname: Duan
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens; D019694:Hepatitis B, Chronic / Q000097:blood / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D012189:Retrospective Studies; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D063065:Organophosphonates; D000077712:Telbivudine; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000225:Adenine; D013936:Thymidine