Views on stopping nucleos(t)ide analogue therapy in patients with chronic hepatitis B.

Views on stopping nucleos(t)ide analogue therapy in patients with chronic hepatitis B. Antiviral Res. 2020 Dec 03;:104992 Authors: Tout I, Lampertico P, Berg T, Asselah T Abstract Long-term treatment with nucleos(t)ide analogs (NAs) is the current first line therapy for patients with chronic hepatitis B (CHB), recommended by most of the current guidelines. NAs prevent disease progression, liver failure, decrease the risk of hepatocellular carcinoma (HCC), and have favorable safety profiles. However, low rates of on-therapy functional cure (hepatitis B surface antigen [HBsAg] loss), which is regarded as the optimal end point, prevent many patients from stopping NA therapy with the need for a lifelong treatment. The higher likelihood of HBsAg loss associated with stopping as compared to continuing NAs has got a lot of attention lately. Recommendations regarding endpoints allowing for safely stopping NA therapy differ between the different international guidelines. Whereas in HBeAg-positive patients, HBeAg seroconversion with at least one year of consolidation therapy is an accepted endpoint of treatment, the recommendations for HBeAg-negative ones differ. Some guidelines propose ≥ 3 years of HBV DNA undetectability to stop NA while others regard HBsAg loss as the only acceptable endpoint to therapy. Stopping NA can lead to substantial rates of virologic relapses and consequent ALT flares in some of them. Moreover, no reliable predict...
Source: Antiviral Research - Category: Virology Authors: Tags: Antiviral Res Source Type: research