Abstract:Objective To analyze the high risk factors of hepatitis B virus (HBV) reactivation caused by anti-tuberculosis drugs in tuberculosis patients with HBsAg positive, and to further explore the preventive effect of entecavir on HBV reactivation after anti-tuberculosis treatment. Methods We retrospectively analyzed the relationship of factors such as age, sex, HBV-DNA load before treatment, history of long-term alcohol consumption, hypoalbuminemia and anti-HBV treatment of entecavir with HBV reactivation after anti-tuberculosis treatment in tuberculosis patients with HBsAg positive. And logistic regression analysis was performed on the factors with statistical significance. Results HBV reactivation occurred in 17 (23.61%) of 72 tuberculosis patients with HBsAg positive after anti-tuberculosis treatment. χ2 test revealed that there were statistically significant differences in age, HBV-DNA load before treatment, history of long-term alcohol consumption, hypoalbuminemia and anti-HBV treatment of entecavir between having and having no HBV reactivation (χ2=7.522, χ2=14.421, χ2=11.466, χ2=4.303, χ2=7.810, all P<0.05). Logistic regression analysis displayed that high level of HBV-DNA before treatment and history of long-term alcoholconsumption were independent risk factors for HBV reactivation after anti-tuberculosis treatment in the tuberculosis patients with HBsAg positive (OR=26.030, 95%CI: 2.402-282.115; OR=27.478, 95%CI: 1.777-424.891), while use of entecavir before anti-tuberculosis treatment was a protective factor for preventing HBV reactivation (OR=0.079, 95%CI: 0.008-0.830). Further analysis showed that the rates of HBV reactivation, liver function damage and forced termination of anti-tuberculosis treatment in the antiviral group using entecavir before anti-tuberculosis treatment were all significantly lower than those in the non-antiviral group (8.82% vs. 36.80%, 17.60% vs. 52.60%, 8.82% vs. 42.10%, all P<0.05). Conclusion High level of HBV-DNA and history of long-term alcohol consumption are independent risk factors for HBV reactivation after anti-tuberculosis treatment in the tuberculosis patients with HBsAg positive. Oral entecavir before anti-tuberculosis treatment can decrease the risk of HBV reactivation and reduce the occurrence of liver function damage.
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