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Long-term outcomes after nucleos(t)ide analogues discontinuation in chronic hepatitis B patients with HBeAg-negative

Dengming He1, Shimin Guo, Wen Chen

  • 1Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, China. wym417@163.com.

BMC Infectious Diseases
|October 5, 2013
PubMed

Insights

Discontinuing nucleos(t)ide analogues (NUCs) is safe for Hepatitis B e Antigen-negative chronic hepatitis B (CHB) patients with undetectable HBV DNA. Prolonging therapy duration can reduce relapse rates, with over 96 weeks of sustained response predicting long-term success.

Area of Science:

  • Hepatology
  • Virology
  • Internal Medicine

Background:

  • Hepatitis B e Antigen (HBeAg)-negative chronic hepatitis B (CHB) signifies active liver disease with risks of cirrhosis and hepatocellular carcinoma.
  • Management of HBeAg-negative CHB patients on nucleos(t)ide analogues (NUCs) requires careful consideration regarding treatment withdrawal.

Purpose of the Study:

  • To evaluate the outcomes of HBeAg-negative CHB patients after discontinuing NUC therapy.
  • To identify factors influencing relapse rates and long-term sustained response post-NUCs withdrawal.

Main Methods:

  • A cohort of 66 HBeAg-negative CHB patients (2 with HBsAg loss, 64 with sustained undetectable HBV DNA) discontinued NUCs.
  • Regular monitoring of HBV DNA and alanine aminotransferase (ALT) levels post-discontinuation.
  • Relapse defined as HBV DNA >2,000 IU/mL on two occasions more than 4 weeks apart.

Main Results:

  • No relapses occurred in patients who achieved HBsAg loss.
  • Among patients with undetectable HBV DNA, 29.7% experienced relapse, all within 96 weeks.
  • No significant differences in baseline characteristics or time to consolidation therapy were observed between relapse and sustained-response groups.

Conclusions:

  • NUC discontinuation is feasible in HBeAg-negative CHB patients with undetectable HBV DNA.
  • Extending the duration before consolidation therapy may lower relapse rates.
  • Sustained response for over 96 weeks predicts long-term sustained virologic response.
Abstract

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