Abstract: Objective The aim of this study was to investigate antiviral efficacy of peginterferon alpha (Peg-IFN-α) and entecavir (ETV) combination in treatment of patients with serum HBeAg-positive chronic hepatitis B (CHB). Methods A total of 279 patients with serum HBeAg-positive CHB were enrolled in this study between January 2019 and January 2022, and were randomly divided into three groups, with 93 cases in each group. Oral entecavir, subcutaneous injection of Peg-IFN-α, or combination of entecavir and Peg-IFN-α were given, and antiviral regimen lasted for 48 weeks. Serum biochemical, serological and virological responses were routinely assessed. Results By end of 48 week treatment, serum HBeAg negative rate and seroconversion rate in combination group were32.3% and 21.5%, in Peg-IFN-α group were 22.6% and 15.1%, while in entecavir group, no serum HBeAg negative and no serum HBeAg conversion; also in combination group, 3.2% of patients had serum HBsAg negative and 2.2% of them had serum HBsAg seroconversion; serum HBsAg and HBeAg levels in combination group were (1.9±0.3)lg s/co and (0.5±0.1)lg s/co, in Peg-IFN-α group were (2.2±0.2)lg s/co and (0.6±0.1)lg s/co, both significantly lower than [(3.6±0.2)lg s/co and (1.3±0.2)lg s/co, P＜0.05] in entecavir group, while serum HBV DNA loads in combination and entecavir groups were much lower than in Peg-IFN-α group (P＜0.05); serum ALT and AST levels in combination group were (30.9±4.5)U/L and (28.4±5.3)U/L, in entecavir group were (31.5±3.6)U/L and (32.3±4.7)U/L, both significantly lower than [(48.1±4.2)U/L and (42.7±5.0)U/L, respectively, P＜0.05] in Peg-IFN-α-treated group. Conclusion Combination of entecavir and Peg-IFN-α in treatment of patients with serum HBeAg-positive CHB could gain satisfactory serum HBeAg negative and seroconversion rates, and in dominant population might obtain functional cure.

Key words: Hepatitis B, Peginterferon alpha, Entecavir, Therapy, Functional cure