Risk factors for low-level viremia in tenofovir disoproxil fumarate-treated chronic hepatitis B patients with advanced hepatic fibrosis/compensated cirrhosis

doi:10.3748/wjg.119706

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Aug 21, 2026; 32(31): 119706
Published online Aug 21, 2026. doi: 10.3748/wjg.119706

Table 1 Baseline clinical characteristics of enrolled patients, n (%)

	Overall (n = 141)	CVR (n = 117)	LLV (n = 24)	P value
Male sex	105 (74.5)	86 (73.5)	19 (79.2)	0.563
Age (year)	43.0	43.0	44.0	0.626
HBV DNA (Log₁₀ IU/mL)	5.7	5.4	7.0	< 0.001
≥ 7	30 (21.3)	14 (12.0)	16 (66.7)	< 0.001
≥ 6	59 (41.8)	41 (35.0)	18 (75.0)	0.001
≥ 5	98 (69.5)	75 (64.1)	23 (95.8)	0.014
HBV RNA (Log₁₀ copies/mL)	5.4	5.2	6.7	< 0.001
≥ 5	88 (62.4)	65 (55.6)	23 (95.8)	0.005
HBeAg positive	72 (51.1)	52 (44.4)	20 (83.3)	0.002
ALT (U/L)	47.0	45.0	58.5	0.083
> ULN¹	61 (43.3)	47 (40.2)	14 (58.3)	0.106
AST (U/L)	38.0	37.8	43.0	0.096
> ULN²	67 (47.5)	54 (46.2)	13 (54.2)	0.474
TBIL (μmol/L)	16.1	16.1	16.9	0.632
Outside the normal range	35 (24.8)	32 (27.4)	3 (12.5)	0.137
DBIL (μmol/L)	4.6	4.5	5.2	0.840
Outside the normal range	26 (18.4)	18 (20.5)	2 (8.3)	0.177
PLT (10⁹/L)	126.0	124.0	127.5	0.522
Outside the normal range	68 (48.2)	59 (50.4)	9 (37.5)	0.252
LSM (kPa)	13.0	13.0	12.9	0.205
≥ 7.2	132 (93.6)	109 (93.2)	23 (95.8)	0.629
≥ 13.0	70 (49.6)	58 (49.6)	12 (50.0)	0.970
AFP (ng/mL)	4.4	4.2	4.8	0.032
≥ 7.0	39 (27.7)	32 (27.4)	7 (29.2)	0.856
Creatinine (μmol/L)	68.0	67.2	70.0	0.692
Outside the normal range	35 (24.8)	31 (26.5)	4 (16.7)	0.315
FIB-4	1.9	1.9	1.9	0.919
< 1.45	49 (34.8)	39 (33.3)	10 (41.7)	0.272
1.45-3.25	62 (44.0)	55 (47.0)	7 (29.2)
≥ 3.25	30 (21.3)	23 (19.7)	7 (29.2)
eGFR [mL/(minute × 1.73 m²)]	109.2	109.9	106.9	0.805
Medication adherence	7 (5.0)	7 (6.0)	0 (0.0)	0.999

¹50 U/L.

²40 U/L.

CVR: Complete virological response; LLV: Low-level viremia; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; PLT: Platelet; LSM: Liver stiffness measurement; AFP: Alpha-fetoprotein; FIB-4: Fibrosis-4 index; eGFR: Estimate glomerular filtration rate; ULN: The upper limit of normal.

Full Size Table

Table 2 Efficacy evaluation at week 48, n/total (%)

	48 weeks
	CVR	LLV	P value
HBV DNA decrease (Log₁₀ IU/mL)	4.5	5.2	< 0.050
HBeAg seroconversion	3/117 (2.6)	1/24 (4.2)	0.670
ALT 48 weeks	35.0	41.0	0.013
Normalized ALT	37/47 (78.7)	8/14 (57.1)	0.870
AST 48 weeks	30.0	30.0	0.128
Normalized AST	44/54 (81.5)	9/13 (69.2)	0.992
HBsAg loss, n (%)	0 (0.0)	1 (4.2)	> 0.999
LSM (kPa)	9.3	9.8	0.256
FIB-4	1.8	2.2	0.478
eGFR [mL/(minute × 1.73 m²)]	108.2	104.1	0.611
Creatinine (μmol/L)	69.0	73.2	0.777

CVR: Complete virological response; LLV: Low-level viremia; HBV: Hepatitis B virus; HBeAg: Hepatitis B e antigen; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HBsAg: Hepatitis B surface antigen; LSM: Liver stiffness measurement; FIB-4: Fibrosis-4 index; eGFR: Estimate glomerular filtration rate.

Full Size Table

Citation: Zhang RL, Zhang HY, Jia YY, Wang ZY, Liu F, Chen HS, Rao HY. Risk factors for low-level viremia in tenofovir disoproxil fumarate-treated chronic hepatitis B patients with advanced hepatic fibrosis/compensated cirrhosis. World J Gastroenterol 2026; 32(31): 119706
URL: https://www.wjgnet.com/1007-9327/full/v32/i31/119706.htm
DOI: https://dx.doi.org/10.3748/wjg.119706

Zhang RL, Zhang HY, Jia YY, Wang ZY, Liu F, Chen HS, Rao HY. Risk factors for low-level viremia in tenofovir disoproxil fumarate-treated chronic hepatitis B patients with advanced hepatic fibrosis/compensated cirrhosis. World J Gastroenterol 2026; 32(31): 119706 [DOI: 10.3748/wjg.119706]

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