Abstract: Objective The aim of this study was to compare antiviral efficacy of pegylated interferon (peg-IFN)-α2b and entecavir (ETV)or tenofovir combination in the treatment of patients with serum HBeAg-positive chronic hepatitis B (CHB). Methods 84 patients with serum HBeAg-positive CHB were enrolled in our hospital between January 2022 and December 2023, and were randomly assigned to receive peg-IFN-α2b and ETV combination in 42 patients or to receive peg-IFN-α2b and tenofovir disoproxil fumarate (TDF) combination for 48 weeks. Serum HBV DNA loads were detected by real-time fluorescence quantitative PCR, serum HBeAg and HBsAg levels were measured by chemiluminescence immunoassay, and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (sCr), β₂-microglobulin (β₂-MG) levels were detected by automatic biochemical analyzer, with estimated glomerular filtration rate (eGFR) calculated by using modified formula of kidney disease. Liver stiffness measurement (LSM) was determined by liver transient elastography. Results By end of 48 weeks of antiviral treatment, serum HBV DNA loss, HBeAg seroconversion and serum ALT normalization rates in peg-IFN-α2b and TDF combination-treated patients were 100.0%, 40.5% and 100.0%, all not significantly different as compared to 100.0%, 40.5% and 100.0% (P>0.05) in peg-IFN-α2b and ETV combination-treated patients; serum ALT, AST and LSM levels were (31.4±4.9)IU/L, (28.4±4.5)IU/L and (6.9±0.8)kPa, all not significantly different compared to [(33.2±4.5)IU/L, (32.1±4.3)IU/L and (6.5±0.9) kPa, P>0.05] in peg-IFN-α2b and ETV combination-treated patients; there were no significant differences as respect to sCr, serum β₂-MG level and eGFR between the two groups (P＞0.05). Conclusion Both peg-IFN-α2b and ETV or TDF combination in the treatment of patients with serum HBeAg-positive CHB have a satisfactory short-term antiviral efficacy, but the long-term outcomes still needs further investigation.

Key words: Hepatitis B, Interferon-α2b, Entecavir, Tenofovir disoproxil fumarate, Hepatitis B virus e antigen, Therapy