Nucleos(t)ide analogues consolidation therapy in HBeAg-positive chronic hepatitis B patients: Three years should be preferred
Tao Li 1 , Yan Liang 2 , Meng Zhang 1 3 , Feng Liu 4 5 , Lixin Zhang 1 , Baohua Yang 1 , Lei Wang 1
Affiliations
Affiliations
1
Department of Infectious Disease and Hepatolgy, the Second Hospital, Cheeloo College of Medicine, Shandong University.
2
Department of Infectious Disease, Jinan Infectious Disease Hospital.
3
Department of Hepatolgy, Jinan Infectious Disease Hospital, Cheeloo College of Medicine, Shandong University.
4
Department of Hepatolgy, Tianjin Second People's Hospital.
5
Tianjin Institute of Hepatology.
PMID: 33772988 DOI: 10.1111/hepr.13641
Abstract
Aim: To assess the role of consolidation therapy after nucleos(t)ide analogues (NAs) cessation for off-treatment outcome and to explore the optimal consolidation period in HBeAg-positive chronic hepatitis B (CHB) patients.
Methods: We performed a prospective, observational cohort study including HBeAg-positive CHB patients discontinuing NAs. Virological relapse was the primary endpoint of the current study and was defined as a serum HBV DNA more than 104 copies/ml (another assay was performed for confirmation at least 2 weeks later). Propensity score matching analysis (PSM) was used to balance the baseline characteristics between HBeAg-positive CHB patients with different consolidation periods.
Results: A total of 190 HBeAg-positive CHB patients were included. Fifty-four patients relapsed during follow-up and the cumulative relapse rates at years 1, 3, 5 and 10 were 19.5%, 24.1%, 27.2% and 32.1%, respectively. Most patients (61.1%) relapsed in the first 6 months. After PSM, significant lower cumulative relapse rates were observed in patients with consolidation period ≥ 36months compared with patients with consolidation period < 36 months (29.3% vs. 52.8% at year 10, p = 0.012).
Conclusions: NAs cessation after HBeAg seroconversion and long-term consolidation is generally safe and feasible in HBeAg-positive CHB patients. Three years of consolidation should be preferred in clinical practice. This article is protected by copyright. All rights reserved.