1015 SAFETY AND EFFICACY OF A VACCINE CONTAINING BOTH HBSAG AND HBCAG IN PATIENTS WITH CHRONIC HEPATITIS B AT BANGLADESH

Introduction: Liver failure often leads to significantly high mortality. Acute-on-chronic liver failure (ACLF) is defined as a syndrome that acute liver decompensation occurs on the patients with chronic liver disease. Particularly in China, chronic hepatitis B (CHB) is the most common cause of ACLF. At present, there is still no definite conclusion on the antiviral therapy for ACLF associated with hepatitis B. Objective: To investigate the short-term efficacy of antiviral therapy on ACLF associated with hepatitis B. Methods: A total of 348 patients with ACLF associated with hepatitis B were divided into two groups (antiviral and control). Antiviral group received the treatment of Lamivudine, Entecavir or Telbivudine combined with the supportive therapy, and control group received the supportive therapy only. The clinical features, survival rate and the short-term antiviral efficacy were compared between these two groups. The SPSS13.0 was used to do the statistical analysis. Comparison of rates from different groups was analyzed using X-test. Enumeration data was done by using analysis of variance. And the survival analysis was done using Kaplan–Meier method, while comparison of survival rates between groups using the log-rank test. Results: Before treatment, there were no significant differences (P > 0.05) between these two groups in demology, baseline HBV DNA level, ratio of HBeAg/anti-HBe, clinical stage of liver failure and liver function tests including TBIL, ALT, AST, ALB, PT and INR. After 4 weeks treatment, differences were statistically significant in both the serum level of TBIL and the decreasing amplitude of HBV DNA between these two groups (t = 2.036, P = 0.042; t=-4.73, P = 0.000). After 24 week treatment, the survival rates of antiviral group with both low (HBV DNA <10 copies/ml) and high (HBV DNA≥10 copies/ml) viral load were higher than those in control group (c = 26.362, P = 0.000; c = 9.47, P = 0.002). Cox regression analysis indicated that antiviral therapy is the favorable factor to influence clinical prognosis.