Association of Dyslipidemia With Nucleoside Analogue Treatment in HBeAg-Positive Chronic Hepatitis B Patients

Abstract BackgroundThe prevalence of dyslipidemia in China is increasing annually. Current studies suggest that dyslipidemia affects the antiviral efficacy of hepatitis C virus (HCV) therapies. Recent studies have shown that serum lipids influence the response rates of chronic hepatitis B patients receiving PEGylated interferon-alpha (Peg IFN-a) treatment. However, the role of dyslipidemia in the efficacy of nucleoside (acid) analogues in chronic hepatitis B patients has not been determined. Methods From January 2010 to December 2013, data from 179 treatment-naive patients with chronic hepatitis B (CHB) who were hepatitis B e antigen (HBeAg)-positive and visited the first affiliated hospital of Wenzhou Medical University were collected. Amongst them, 68 patients were diagnosed with CHB complicated with dyslipidemia (dyslipidemia group) whilst 111 patients comprised the lipid control group. Three treatment strategies were performed amongst the 179 CHB patients over a 5 year period. Treatments included combination therapy of lamivudine (LAM) plus adefovir dipivoxil (ADV), telbivudine (LdT) monotherapy or entecavir (ETV) monotherapy. Serum assessments, blood biochemistry, HBV serological markers, HBV DNA before treatment and HBeAg serological conversion and virological responses at different time points after treatment were compared between the two groups. Measurement data were compared using τ tests, whilst enumeration data were compared using c2 tests. Correlation analysis was performed using binary Logistic regression analysis. Results The rates of HBeAg seroconversion in the dyslipidemia group at years 1, 2, 3 and 4 were 10.3%, 13.2%, 17.6% and 22.1%, respectively, which were not significantly lower than those of the lipid control group 11.7%, 16.2%, 18.0% and 33.3%, (c2 = 0.085, 0.293, 0.004 and 2.601, respectively; R > 0.05). However, the rates of HBeAg seroconversion in the dyslipidemia group were significantly lower than those of the lipid control group at year 5 (27.9% vs 43.2%, c2 =4.216, R<0.05). Univariate logistic regression analysis showed significant differences in sex PTA, ALT, AST, CR and LDL-C. Multivariate regression analysis demonstrated that dyslipidemia (OR=1.993, R=0.038), and male gender (OR=2.317, R=0.029) were risk factors associated with HBeAg seroconversion.Conclusions During antiviral therapy, dyslipidemia affects HBeAg seroconversion in CHB patients treated with nucleoside (acid) analogues but does not affect the virological response.