Saudi Journal of Gastroenterology
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Year : 2015  |  Volume : 21  |  Issue : 4  |  Page : 245-253

Predictors of sustained virologic response after discontinuation of nucleos(t)ide analog treatment for chronic hepatitis B

State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infescious Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

Correspondence Address:
Jie Peng
State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious diseases, Nanfang Hospital, Southern Medical University No. 1838 Guangzhou Road, Guangzhou 510515
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Source of Support: This study was supported by Guangdong Natural Science Foundation (S2013010014658), Chinese Foundation for Hepatitis Prevention, and Control-TianQing Liver Disease Research Fund Subject (TQGB2011001), Conflict of Interest: None declared.

DOI: 10.4103/1319-3767.161645

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Background/Aims: The aim of this study was to identify the predictors for relapse after discontinuation of oral nucleos(t)ide analog treatment for chronic hepatitis B (CHB). Patients and Methods: We evaluated patients who were receiving long-term, regular antiviral therapy with nucleos(t)ide analogs, and subsequently achieved the discontinuation criteria from the Asia-Pacific guideline. After they voluntarily discontinued the drug therapy, data were prospectively collected to observe the potential virologic relapse, and the parameters that predicted recurrence were analyzed. Results: Sixty-five patients met the inclusion criteria, and were included in this study. Twenty-eight patients relapsed, and the accumulative recurrence rates at the 3-month, 6-month, and 1-year follow-ups were 13.85%, 32.31%, and 49.23%, respectively. There was no difference in the accumulative recurrence rate 12 months after discontinuation among patients who were positive or negative for the hepatitis B e antigen (HBeAg) before they received the medication. Logistic regression analysis revealed that the time to complete response, age at discontinuation, and HBsAg levels at discontinuation affected the rate of relapse. Conclusions: Among patients who received orally administrated nucleos(t)ide analogs, serum levels of HBsAg, age at discontinuation, and the time to complete response might be used as a guide to discontinue treatment. Among younger patients, those with low serum HBsAg levels, and those with an earlier complete response, the risk of relapse is lower and discontinuation is much safer.

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