Clin Mol Hepatol.  2013 Sep;19(3):300-304. 10.3350/cmh.2013.19.3.300.

Durability after discontinuation of nucleos(t)ide therapy in chronic HBeAg negative hepatitis patients

• Kim YJ
• Kim K
• Hwang SH
• Kim SS
• Lee D
• Cheong JY
• Cho SW

• KMID: 1705208
• DOI: http://doi.org/10.3350/cmh.2013.19.3.300

Abstract

BACKGROUND/AIMS
Relapse has been reported after stopping nucleos(t)ide (NUC) therapy in the majority of chronic HBeAg negative hepatitis patients. However, the ideal treatment duration of HBeAg negative chronic hepatitis B (CHB) is not well known. We investigated the frequency of relapse in HBeAg negative CHB patients receiving NUC therapy.
METHODS
The NUC therapy was discontinued at least 3 times undetectable level of HBV DNA leave 6 months space in 45 patients. Clinical relapse was defined as HBV DNA >2,000 IU/mL and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2 times of upper limit of normal range. Virological relapse was defined as HBV DNA >2,000 IU/mL.
RESULTS
Clinical relapse developed in 16 (35.6%) and 24 (53.3%) patients after stopping therapy at 6 months and 12 months off therapy, respectively. Virological relapse developed 22 (48.9%) and 33 (73.3%) patients at 6 months and 12 months off therapy. The factors such as age, gender, cirrhosis, baseline AST, ALT, HBV DNA levels, treatment duration, and consolidation duration were analyzed to investigate the predictive factors associated with 1 year sustained response. Of these factors, cirrhosis (86.1% in CHB, 22.2% in LC) was significantly associated with 1 year virological relapse rate. Baseline HBV DNA and total treatment duration tended to be associated with virological relapse.
CONCLUSIONS
Virological relapse developed in the majority (73.3%) of HBeAg negative CHB patients and clinical relapse developed in the half (53.3%) of patients at 1 year off therapy. Cirrhosis may be associated with the low rate of virological relapse.

Keyword

Chronic hepatitis B; Durability; Nucleos(t)ide analogue

MeSH Terms

Adult
Age Factors
Alanine Transaminase/blood
Antiviral Agents/*therapeutic use
Aspartate Aminotransferases/blood
DNA, Viral/analysis
Drug Administration Schedule
Female
Hepatitis B e Antigens/*analysis
Hepatitis B virus/genetics
Hepatitis B, Chronic/complications/*drug therapy/virology
Humans
Liver Cirrhosis/diagnosis/etiology
Male
Middle Aged
Nucleotides/*therapeutic use
Recurrence
Sex Factors
Alanine Transaminase
Antiviral Agents
Aspartate Aminotransferases
DNA, Viral
Hepatitis B e Antigens
Nucleotides