Hepatitis B surface antigen loss after discontinuing nucleos(t)ide analogue for treatment of chronic hepatitis B patients is persistent in White patients. Issue 2 (February 2019)

• Record Type: Journal Article
• Authors: Suárez, Emilio; Buti, María; Rodríguez, Manuel; Prieto, Martín; Pascasio-Acevedo, Juan M.; Casanovas, Teresa; Crespo, Javier; Tapiador, Juan Arenas Ruiz; Gómez-Rodríguez, Rafael; Figueruela, Blanca; Diago, Moisés; Morillas, Rosa M.; Zozaya, José M.; Calleja, José L.; Casado, Marta; Molina, Esther; Fuentes, Javier; Simón, Miguel A.
• Is Part Of: European journal of gastroenterology & hepatology. Volume 31:Issue 2(2019)
• Publication Date: 2019-02
• Subjects: chronic hepatitis B -- hepatitis B surface antigen -- hepatitis B virus reactivation -- hepatocellular carcinoma -- nucleos(t)ide analogue treatment; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000001289
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Objective: The objective of this study was to determine the long-term clinical outcome and persistence of hepatitis B surface antigen (HBsAg) loss after discontinuation of treatment. Background: The prognosis of patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs) who discontinue treatment after loss of HBsAg remains largely unknown, particularly in White patients. Patients and methods: We analysed a cohort of patients with CHB who discontinued NA treatment after loss of HBsAg. A total of 69 patients with hepatitis-B-e antigen-positive or hepatitis-B-e antigen-negative CHB with undetectable HBsAg during NA treatment were included after discontinuation of treatment, and followed up for a median period of 37.8 months (interquartile range: 23.8–54.6 months). Results: At the end of follow-up, none of the patients showed spontaneous reappearance of HBsAg and only one patient had detectable hepatitis B virus DNA (22 IU/ml). Another patient negative for HBsAg and anti-HBs developed hepatitis B virus reactivation without elevated transaminases after treatment with corticosteroids and vincristine for dendritic cell neoplasm, 38 months after withdrawal of the antiviral treatment. Regarding clinical outcome, a patient with cirrhosis developed hepatocellular carcinoma, 6.6 years after discontinuing treatment. None of the patients had hepatic decompensation or underwent liver transplantation. Conclusion: HBsAg clearance after discontinuing NAs in patients with CHB is persistent and associated with good prognosis. The risk for developing hepatocellular carcinoma persists among patients with cirrhosis.