Abstract: Objective The aim of this study was to explore the antiviral efficacy of entecavir (ETV) and pegylated interferon α-2b (PEG-IFNα-2b) combination in treatment of patients with low serum level HBsAg-positive chronic hepatitis B (CHB). Methods A total of 96 patients with low serum level HBsAg-positive CHB were enrolled in our hospital between January 2018 and January 2020, and were randomly divided into control and observation group, with 48 cases in each group. The patients in the control group were treated with orally ETV and those in the observation were treated with ETV and PEG-IFNα-2b combination for 48 weeks. Serum HBV DNA loads were detected by fluorescence quantitative polymerase chain reaction, and serum HBsAg and HBeAg levels were detected by electrochemiluminescence. The percentages of CD3⁺, CD4⁺ and CD8⁺ cells were detected by flow cytometry, and ratio of CD4⁺/CD8⁺ cells was calculated. Results At the end of 48 week observation, serum HBsAg and HBeAg levels in the observation group were (809.8±101.5)IU/mL and (193.4±24.5)IU/mL, both significantly lower than [(1201.7±204.9)IU/mL and (244.2±5.7)IU/mL, respectively, P<0.05] in the control; serum HBeAg negative rate was 29.2%, significantly higher than 4.2%(P<0.05) in the control, and the HBeAg seroconversion rate was 12.5% and serum HBsAg loss was 8.3%; serum ALT and AST levels were (52.5±4.6)U/L and (45.1±5.2)U/L, both significantly lower than [(63.4±5.2)U/L and (68.2±5.4)U/L, respectively, P<0.05] in the control; the percentages of peripheral blood CD3⁺ and CD4⁺ cells and the ratio of CD4⁺/CD8⁺ cells were (68.5±4.2)%, (38.1±3.6)% and (1.8±0.5), all significantly higher than [(57.4±3.8)%, (32.6±3.1)% and (1.1±0.4), respectively, P<0.05], while the percentage of CD8⁺ cells was(21.3±1.8)%, significantly lower than [(28.7±2.0)%, P<0.05] in the control group. Conclusion The regimen with ETV and PEG-IFNα-2b combination in treating CHB patients with low serum HBsAg positive could gain a good antiviral efficacy, with serologic response in some cases, which might be related to the improved immune functions.

Key words: Hepatitis B, Entecavir, Pegylated interferon α-2b, HBsAg, Antiviral response