Objective: To investigate the clinical features and the short-term efficacy of ETV treatment of 132 HBeAg negative and 51 HBeAg the HBeAg negative acute-on-chronic hepatitis B liver failure.
Methods: positive patients with acute-on-chronic liver failure were rolled. 84 patients were treated with ETV (0.5 mg daily) and routine supportive therapy. 99 patients in the control group received supportive therapy only. The clinical features and the short-term (180 days) efficacy of ETV were compared between the HBeAg negative and HBeAg positive groups.
Results: The age of HBeAg negative patients was significantly higher (P = 0.001). The viral load was significantly higher in the HBeAg positive group (P = 0.001). There was no significant difference in the severity and the mortality in control group between the different HBeAg groups. In the antiviral treatment groups, 20/25 HBeAg positive patients survived and 32/59 HBeAg negative patients survived (P = 0.004). The mortality of HBeAg negative patients in control group was higher than that in treatment group (P = 0.032). In HBeAg negative patients with the HBV DNA <5 log copies/ml and HBV DNA >3 log copies/ml, 10/18 patients in treatment group survived and 6/30 patients in control group survived (P = 0.011).
Conclusions: There was no significant difference in the mortality between different HBeAg patients in routine treatment group. Antiviral therapy with ETV significantly improve survival rate in HBeAg negative patients. In patients with the HBeAg negative and HBV DNA <5 log copies/ml and >3 log copies/ml, antiviral therapy with ETV can improve the survival rate.