Can we stop nucleoside analogues before HBsAg loss?
Margarita Papatheodoridi1, George Papatheodoridis1
1Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Athens, Greece.
Journal of Viral Hepatitis
|February 26, 2019
Summary
Stopping nucleos(t)ide analogues (NAs) is feasible for select chronic hepatitis B patients with sustained remission. Close monitoring post-discontinuation is crucial for managing relapses and identifying HBsAg loss.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Current guidelines permit stopping nucleos(t)ide analogue (NA) therapy in select chronic hepatitis B (CHB) patients.
- Long-term NA therapy can achieve sustained virological remission in many CHB patients.
Purpose of the Study:
- To evaluate the outcomes of NA discontinuation in CHB patients with sustained virological remission.
- To identify predictors of relapse and factors influencing HBsAg loss after NA cessation.
Main Methods:
- Retrospective analysis of CHB patients who discontinued NA therapy after achieving long-term remission.
- Monitoring for virological and biochemical relapse, HBsAg loss, and need for retreatment.
Main Results:
- Most patients experienced post-NA virological relapse, with a subset having biochemical relapse or flares.
- HBsAg loss occurred in an increasing proportion of patients, higher in Caucasians with HBeAg-negative CHB.
- No reliable predictors for post-NA relapse were identified.
Conclusions:
- NA discontinuation is a viable strategy for carefully selected CHB patients with sustained remission.
- Close monitoring and prompt retreatment are essential to manage relapses and flares.
- HBsAg loss is an achievable outcome in a subset of patients after NA cessation.
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