Korean J Gastroenterol.  2020 Nov;76(5):256-260. 10.4166/kjg.2020.111.

Seroreversion and Acute Decompensation in Chronic Hepatitis B after Discontinuation of Oral Nucleotide Analog in the Patients Achieving HBsAg Loss

• Cho HJ
• Shin SK
• Kwon OS
• Kim JH
• Kim YS

• KMID: 2508876
• DOI: http://doi.org/10.4166/kjg.2020.111

Abstract

Although rare patients with chronic hepatitis B can achieve HBsAg loss on oral nucleos(t)ide analog (NA), the optimal timing of stopping oral NAs safely has been considered when HBsAg and HBV DNA are negative in the serum because HBsAg loss induced by nucleos(t)ide analogs (NAs) appears to be durable if immunosuppressive therapy or chemotherapy are not done. On the other hand, the author experienced a case of HBsAg seroreversion and acute decompensation after the discontinuation of NA in a patient with HBsAg loss. This rare case highlights the need for the close monitoring of patients who achieved HBsAg loss and stopped NA.

Keyword

Hepatitis B virus; Functional cure; HBsAg loss; HBsAg reversion; Nucleos(t)ide analogues

Figure

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  Fig. 1 Abdominal ultrasonography performed immediately after hospitalization. Coarse echo of the liver parenchyma and nodularity of liver surface can be observed. There is no recurrence of hepatocellular carcinoma or ascites.

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  Fig. 2 Liver dynamic magnetic resonance imaging showed no evidence of tumor recurrence.

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  Fig. 3 The patient complained of abdominal distension, and follow-up ultrasonography was performed. (A) Nodular liver surface and (B) moderate ascites are observed.

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