Korean J Gastroenterol.
2016 Jan;67(1):28-34. 10.4166/kjg.2016.67.1.28.
Predictive Factors for Sustained Remission after Discontinuation of Antiviral Therapy in Patients with HBeAg-positive Chronic Hepatitis B
- Affiliations
-
- 1Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. khskhs@schmc.ac.kr
- 2Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
- 3Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
- 4Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
- KMID: 2373390
- DOI: http://doi.org/10.4166/kjg.2016.67.1.28
Abstract
- BACKGROUND/AIMS
The optimal timing for discontinuing oral antiviral therapy in patients with HBeAg-positive chronic hepatitis B (CHB) is unclear. The aim of our study was to investigate sustained remission after stopping antiviral therapy in patients with HBeAg-positive CHB.
METHODS
We analyzed the medical records of 58 patients who were HBeAg-positive and had discontinued antiviral therapy. Antiviral therapy was discontinued after HBeAg seroconversion and HBV DNA negativity for 6-12 months with consolidation therapy. Virologic relapse was defined as an increase in serum HBV DNA >2,000 IU/mL.
RESULTS
No difference was observed between the virologic non-relapse and virologic relapse groups in baseline HBV DNA level (p=0.441) or duration of seroconversion (p=0.070). Time-to-undetectable HBV DNA during treatment was shorter in the virologic non-relapse group (29 patients) compared to the relapse group (29 patients) (4.9+/-2.6 vs. 13.2+/-12.7 months; p<0.01). Cumulative relapse rates were 12.7 in month 3, 32.7 in month 6, 47.3 in month 12, and 52.7% in month 18. We determined by multivariate analysis that the consolidation period (> or =18 months, p=0.020) and early virologic response (HBV DNA <20 IU/mL) at six months during antiviral therapy (p=0.017) were significant predictors for sustained remission.
CONCLUSIONS
A consolidation period of at least 18 months and early virological response at six months during antiviral therapy were associated with sustained remission in patients with HBeAg-positive CHB after treatment.
Keyword
MeSH Terms
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Adult
Aged
Antiviral Agents/*therapeutic use
DNA, Viral/analysis
Female
Hepatitis B e Antigens/*blood
Hepatitis B virus/genetics/isolation & purification
Hepatitis B, Chronic/*drug therapy
Humans
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Recurrence
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Withholding Treatment
Antiviral Agents
DNA, Viral
Hepatitis B e Antigens
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