Poor adherence is a contributor to viral breakthrough in patients with chronic hepatitis B Liguo Wang,1,* Peng Chen,2,* Chao Zheng3 1Department of Infectious Diseases, First Affiliated Hospital of Xiamen University, Fujian Province, China; 2Department of Emergency, Xinglin Hospital, First Affiliated Hospital of Xiamen University, Fujian Province, China; 3Department of Respiratory, First Affiliated Hospital of Xiamen University, Fujian Province, China *These authors contributed equally to this work Objective: The objective of this study was to explore the risk factors of poor adherence of nucleoside analogs (NUC) treatment in chronic hepatitis B (CHB) patients and the virological changes in patients with poor adherence. Subjects and methods: A total of 205 CHB patients were enrolled. The patients’ demographic data and family history were collected. NUC adherence was calculated every 12 weeks as follows: number of NUC tablets taken by the patients was divided by the number of NUC tablets prescribed. NUC adherence > 90% was defined as good adherence of NUC treatment. Results: NUC adherence of male patients was significantly lower than that of female patients. Adherence among patients with previous NUC treatment was poorer than that of patients without previous NUC treatment. Multivariate analysis indicated that female gender (