Stopping nucleot(s)ide analogues in non-cirrhotic HBeAg-negative chronic hepatitis B patients: HBsAg loss at 96 weeks is associated with low baseline HBsAg levels.

2022-05-06

Hall, Samuel A L

Burns, Gareth S

Anagnostou, Despina

Vogrin, Sara

Sundararajan, Vijaya

Ratnam, Dilip

Levy, Miriam T

Lubel, John S

Nicoll, Amanda J

Strasser, Simone I

Sievert, William

Desmond, Paul V

Ngu, Meng C

Angus, Peter W

Sinclair, Marie

Meredith, Christopher

Matthews, Gail

Revill, Peter A

Jackson, Kathy

Littlejohn, Margaret

Bowden, D Scott

Locarnini, Stephen A

Visvanathan, Kumar

Thompson, Alexander J

Journal Article

0000-0001-7158-585X

0000-0003-0657-3048

0000-0001-8505-2317

10.1111/apt.16968

Current guidelines recommend long-term nucleot(s)ide analogue (NA) therapy for patients with HBeAg-negative chronic hepatitis B (CHB). However, disease remission has been described after stopping NA therapy, as well as HBsAg loss. We performed a prospective multi-centre cohort study of stopping NA therapy. Inclusion criteria were HBeAg-negative CHB, the absence of cirrhosis and HBVDNA5× ULN occurred in 35 (32%); ALT flares were not associated with HBsAg loss. There were no unexpected safety issues. Virological reactivation was very common after stopping NA therapy and occurred earlier after stopping TDF versus ETV. The majority of patients had ALT <2× ULN at week 96, but only one-third achieved disease remission and HBsAg loss was rare. Very low HBsAg levels at baseline were uncommon but predicted for HBsAg loss and disease remission.

link

Alimentary Pharmacology & Therapeutics 2022; 56(2): 310-320

Alimentary Pharmacology & Therapeutics