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Clin Microbiol Infect. 2017 Dec 26. pii: S1198-743X(17)30688-2. doi: 10.1016/j.cmi.2017.12.013. [Epub ahead of print]
Long-term incidence and predictors of hepatitis B surface antigen loss after discontinuing nucleoside analogues in non-cirrhotic chronic hepatitis B patients.Chen CH1, Hung CH2, Wang JH2, Lu SN2, Hu TH2, Lee CM2.
Author information
1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan. Electronic address: [email protected].2Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan.
AbstractOBJECTIVES: This study investigates the long-term incidence and predictors for hepatitis B surface antigen (HBsAg) loss after nucleoside analogue (NA) therapy.
METHODS: The study included 411 non-cirrhotic chronic hepatitis B (CHB) patients (148 hepatitis B e antigen (HBeAg)-positive and 263 HBeAg-negative patients) who were treated with lamivudine (n=110) or entecavir (n=301) with post-treatment follow-up of at least 12 months.
RESULTS: In HBeAg-positive patients, the 8-year cumulative rates of virological relapse, clinical relapse, and HBsAg loss were 55.6%, 47.7%, and 19.6%, respectively. In HBeAg-negative patients, the rates were 69.3%, 58.9%, and 33.1%, respectively. Cox regression analysis showed that HBV genotype C and lower end-of-treatment HBsAg levels were independent predictors of HBsAg loss in HBeAg-positive and HBeAg-negative patients. The 5-year HBsAg loss rate was 47.3% in HBeAg-positive patients with end-of-treatment HBsAg levels <300 IU/mL, while the 8-year HBsAg loss rate was 69.3% in HBeAg-negative patients with end-of-treatment HBsAg levels <200 IU/mL. Five patients experienced hepatitis flares with decompensation after stopping NA therapy, and one died after retreatment. Of the 48 patients who developed off-therapy HBsAg loss, 2 developed hepatocellular carcinoma.
CONCLUSIONS: The rate of HBsAg loss was relatively high and the rate of hepatic events was low in non-cirrhotic patients who discontinued NA therapy.
Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
KEYWORDS: antiviral therapy; hepatitis B surface antigen, entecavir; hepatitis B virus; lamivudine
PMID:29288020DOI:10.1016/j.cmi.2017.12.013
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