Discontinuation of antiviral therapy in chronic hepatitis B patients  

作　　者：Renato Medas Rodrigo Liberal Guilherme Macedo 

机构地区：[1]Department of Gastroenterology and Hepatology,Centro Hospitalar Universitario de São João,Porto 4200-319,Portugal

出　　处：《World Journal of Clinical Cases》2021年第24期6979-6986,共8页世界临床病例杂志

摘　　要：Nucleos(t)ide analogs(NUC)are the first-line therapy for patients with chronic hepatitis B(CHB)recommended by most current guidelines.NUC therapy decreases progression of liver disease,reduces the risk of liver-related complications,and improves the quality of life of patients with CHB.Although indefinite or long-term NUC therapy is usually recommended,this strategy raises several concerns,such as side-effects,adherence,costs,and patient willingness to stop therapy.Recent data showed the feasibility,efficacy,and safety of stopping antiviral therapy in carefully selected CHB patients,leading to its incorporation in international guidelines.Patients who discontinue NUC have a higher likelihood of hepatitis B surface antigen(HBsAg)loss compared to patients who continue on therapy.Recommendations pertaining endpoints allowing safety discontinuation of NUC therapy differ among international guidelines.For hepatitis B e antigen(HBeAg)-positive patients,durable HBeAg seroconversion is considered an acceptable treatment endpoint.For HBeAg-negative patients,some guidelines propose undetectability hepatitis B virus DNA for at least 2 or 3 years,while others consider HBsAg loss as the only acceptable endpoint.CHB patients who stop therapy should remain under strict clinical and laboratorial follow-up protocols to detect and manage relapses in a timely manner.No reliable predictor of relapse has been consistently identified to date,although quantitative HBsAg has been increasingly studied as a reliable biomarker to predict safe NUC discontinuation.

关 键 词：Chronic hepatitis B Finite therapy Hepatitis B surface antigen loss RELAPSE RETREATMENT 

分 类 号：R512.62[医药卫生—内科学]