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- 2022-12-28
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Cessation of Nucleoside/Nucleotide Analogue Therapy in Chronic Hepatitis B HBeAg-Negative Patients
Paul J Pockros 1 2 , Ashwini Mulgaonkar 1
Affiliations
Affiliations
1
Division of Gastroenterology/Hepatology, Scripps Clinic, La Jolla, California.
2
Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, California.
PMID: 36398137 PMCID: PMC9666823
Abstract
Most patients treated for chronic hepatitis B infection require lifelong treatment with nucleoside/nucleotide analogues (NAs), which inhibit hepatitis B virus (HBV) replication but do not eradicate the virus or achieve a functional cure. Withdrawal of NA treatment is being considered as a path to functional cure by provoking HBV reactivation, followed by immune consolidation and subsequent hepatitis B surface antigen loss in some patients. However, in rare cases, NA therapy withdrawal causes severe hepatitis flares, hepatic decompensation, or death, and predictors of hepatic decompensation or death with NA withdrawal have not been well established. This article reviews the current standard of care for HBV and the results of recent trials that clarify the safety of NA treatment cessation relative to the benefit of functional cure.
Keywords: Nucleoside analogues; acute liver failure; chronic hepatitis B; functional cure; hepatic decompensation; nucleotide analogues; relapse.
Copyright © 2022, Gastro-Hep Communications, Inc. |
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发表于 2022-11-19 12:32