Long‐term clinical outcome of HBeAg‐negative chronic hepatitis B patients who discontinued nucleos(t)ide analogues. (29th December 2020)

• Record Type: Journal Article
• Authors: Manolakopoulos, Spilios; Kranidioti, Hariklia; Kourikou, Anastasia; Deutsch, Melanie‐Maria; Triantos, Christos; Tsolias, Chrysostomos; Manesis, Emanuel K.; Mathou, Nicoletta; Alexopoulou, Alexandra; Hadziyannis, Emilia; Papatheodoridis, George
• Is Part Of: Liver international. Volume 41:Number 1(2021)
• Page Start: 48
• Page End: 57
• Publication Date: 2020-12-29
• Subjects: HBsAg clearance -- retreatment rates -- treatment discontinuation -- virological relapse; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.14654
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background & Aims: Discontinuation of nucleos(t)ide analogues (NA) remains a debatable issue in HBeAg‐negative chronic hepatitis B (CHB). This study aimed to address the outcome of HBeAg‐negative CHB patients who discontinued NA therapy. Methods: This prospective study included 57 non‐cirrhotic HBeAg‐negative Caucasian CHB patients who discontinued NA therapy after median virological remission of 6 years. All patients had regular blood tests. Virological relapse was defined as HBV DNA > 2000 IU/mL or >20 000 IU/mL and biochemical relapse as ALT > ULN (40 IU/mL) or >2xULN. All patients with retreatment predefined criteria restarted entecavir or tenofovir. Results: Of the 57 patients, 29 remained without retreatment after median follow‐up of 65 months (range: 36‐87) following treatment discontinuation. At 3, 6, 12, 24, 36 and 48 months, cumulative rates of retreatment were 16%, 20%, 32%, 35%, 46% and 50%, while the proportion of patients with HBV DNA < 2000 IU/mL and ALT < ULN were 73%, 60%, 52%, 52%, 47% and 37% respectively. All patients had virological and biochemical response after retreatment. No patient developed liver failure, hepatocellular carcinoma or death. Cumulative rates of HBsAg loss were 2%, 4%, 7%, 10% and 20% at 3, 6, 12, 24 and 36 months. HBsAg levels < 100 IU/mL at the end of NA treatment could predict HBsAg loss ( P = .001). Conclusions: Our study supports that NA therapy can be safely stopped in non‐cirrhotic patients with HBeAg‐negative CHB. Over a median follow‐up of more than 5 years, half of the patients remained without retreatment with a substantial proportion of them achieving functional cure.