To investigate the influence factors of liver fibrosis reversal in patients with chronic hepatitis B (CHB) who received tenofovir alafenamide fumarate and received virological response.

A retrospective analysis was conducted on the medical records of 120 patients with CHB who received tenofovir propofol marinate treatment in Xuzhou Infectious Disease Hospital from November 2023 to Febuary 2024, and all patients received treatment for 12 months. According to the presence or absence of hepatic fibrosis reversal, 120 patients who received a virological response were divided into a hepatic fibrosis reversal group (n=44) and a non-hepatic fibrosis reversal group (n=76). The viral load, liver function indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL)], liver fibrosis indexes [hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC-Ⅲ), type Ⅳ collagen (Ⅳ-C)] and liver hardness of 120 patients were compared before treatment and 3 months after treatment. The viral load, liver function indexes and liver hardness values of patients with and without liver fibrosis reversal were compared. Logistic regression was used to analyze the factors influencing the reversal of liver fibrosis in CHB patients who received tenofovir alafenamide fumarate and received virological response.

The HBV DNA, ALT, AST, TBIL, HA, LN, PCⅢ, Ⅳ-C and liver hardness values of CHB patients after 3 months of treatment were significantly lower than those before treatment, with statistically significant differences (P<0.05). There was no significant difference in gender, age, drinking history, smoking history, pre-treatment ALT, pre-treatment AST and pre-treatment TBIL levels between the two groups (P>0.05). The HBV DNA and liver hardness values before treatment of patients without liver fibrosis reversal group were significantly higher than those of patients with liver fibrosis reversal group, with statistically significant differences (P<0.05). Logistic regression analysis showed that the high levels of HBV DNA and liver hardness before treatment were the factors influencing the reversal of liver fibrosis in CHB patients treated with tenofovir alafenamide fumarate and receiving virological response (P<0.05).

The high expression of HBV DNA and liver hardness before treatment are influential factors for the reversal of liver fibrosis in CHB patients who receive tenofovir alafenamide fumarate treatment and obtain virological response, early intervention and close monitoring should be carried out in clinical practice to improve the therapeutic effect and delay the progression of fibrosis.