The times they are a-changing – A refined proposal for finite HBV nucleos(t)ide analog therapy

Although discontinuation of nucleos(t)ide analogue (NA) treatment before HBsAg loss is part of all current hepatitis B virus (HBV) treatment guidelines for HBeAg-positive patients who achieved HBeAg seroconversion, a treatment endpoint known to be associated with silencing of HBV transcriptional activity and restoration of HBV-specific immune control, it is still highly controversial whether it is even appropriate to consider NA discontinuation before HBsAg loss in the HBeAg-negative phase. Despite the growing evidence that a relevant, albeit small, proportion of patients with HBeAg-negative disease can be cured by stopping NA treatment, the fear of discontinuation-associated relapse and the uncertainty of how to predict off-therapy response and monitor patients after discontinuation have generated scepticism and subsequently led to low implementation of this concept in the clinic.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Expert Opinion Source Type: research