Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study
Introduction: The optimal duration of nucleos(t)ide analogues (NAs) therapy is unknown for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The European Association for the Study of the Liver (EASL) recommends the cessation of NAs in selected non-cirrhotic HBeAg-negative pa...
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| Format: | Article |
| Language: | Turkish |
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Galenos Yayinevi
2020-12-01
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| Series: | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| Subjects: | |
| Online Access: | http://mjima.org/abstract.php?id=216 |
| _version_ | 1797920269325565952 |
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| author | Figen SARIGÜL Ülkü USER |
| author_facet | Figen SARIGÜL Ülkü USER |
| author_sort | Figen SARIGÜL |
| collection | DOAJ |
| description | Introduction: The optimal duration of nucleos(t)ide analogues (NAs) therapy is unknown for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The European Association for the Study of the Liver (EASL) recommends the cessation of NAs in selected non-cirrhotic HBeAg-negative patients achieving long-term (at least three years) virological suppression under treatment if close monitoring can be guaranteed after the cessation of NAs. This study aimed to test this “cut-off rule” in HBeAg-negative CHB patients treated with NAs.
Materials and Methods: Seventy-one non-cirrhotic patients were treated with NAs for an average of nine (3-14) years before treatment was discontinued, and patients’ hepatitis B virus (HBV) DNAs were negative for an average of seven (3-13) years. After treatment cessation, serum HBV-DNA and alanine aminotransferase levels were monitored every four weeks for the first six months and every three months from six months to 12 months. The patients were followed-up for 48 weeks after treatment cessation.
Results: In 48 weeks after NA treatment cessation, 30 of 71 patients (42.3%) experienced relaps. Hepatitis B e antigen seroreversion in two consecutive visits was observed in one patient (3.4%), HBV-DNA >20,000 IU/ml twice was observed in 23 patients (76.6%), and both virological and biochemical relapses were observed in six patients (20%). Median retreatment time was 21.6 (4-48) weeks. There were no significant differences between relapsers and non-relapsers in terms of baseline features.
Conclusion: Although the viral suppression time in NA treatment of HBeAg-negative CHB patients was longer than the EASL recommendation, the relapse rate was found to be similar to that in other studies. Our study has shown that applying EASL recommendations in patients meeting the suitable criteria who can be closely followed up is appropriate. |
| first_indexed | 2024-04-10T13:58:27Z |
| format | Article |
| id | doaj.art-20ba5a96a1d541a1bef2a04114b715cc |
| institution | Directory Open Access Journal |
| issn | 2147-673X |
| language | Turkish |
| last_indexed | 2024-04-10T13:58:27Z |
| publishDate | 2020-12-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| spelling | doaj.art-20ba5a96a1d541a1bef2a04114b715cc2023-02-15T16:10:20ZturGalenos YayineviMediterranean Journal of Infection, Microbes and Antimicrobials2147-673X2020-12-019110.4274/mjima.galenos.2020.2020.14Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center StudyFigen SARIGÜL0Ülkü USER1University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Infectious Disease and Clinical Microbiology, Antalya, TurkeyUniversity of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Infectious Disease and Clinical Microbiology, Antalya, TurkeyIntroduction: The optimal duration of nucleos(t)ide analogues (NAs) therapy is unknown for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The European Association for the Study of the Liver (EASL) recommends the cessation of NAs in selected non-cirrhotic HBeAg-negative patients achieving long-term (at least three years) virological suppression under treatment if close monitoring can be guaranteed after the cessation of NAs. This study aimed to test this “cut-off rule” in HBeAg-negative CHB patients treated with NAs. Materials and Methods: Seventy-one non-cirrhotic patients were treated with NAs for an average of nine (3-14) years before treatment was discontinued, and patients’ hepatitis B virus (HBV) DNAs were negative for an average of seven (3-13) years. After treatment cessation, serum HBV-DNA and alanine aminotransferase levels were monitored every four weeks for the first six months and every three months from six months to 12 months. The patients were followed-up for 48 weeks after treatment cessation. Results: In 48 weeks after NA treatment cessation, 30 of 71 patients (42.3%) experienced relaps. Hepatitis B e antigen seroreversion in two consecutive visits was observed in one patient (3.4%), HBV-DNA >20,000 IU/ml twice was observed in 23 patients (76.6%), and both virological and biochemical relapses were observed in six patients (20%). Median retreatment time was 21.6 (4-48) weeks. There were no significant differences between relapsers and non-relapsers in terms of baseline features. Conclusion: Although the viral suppression time in NA treatment of HBeAg-negative CHB patients was longer than the EASL recommendation, the relapse rate was found to be similar to that in other studies. Our study has shown that applying EASL recommendations in patients meeting the suitable criteria who can be closely followed up is appropriate.http://mjima.org/abstract.php?id=216chronic hepatitis bhepatitis b e antigentreatment cessation |
| spellingShingle | Figen SARIGÜL Ülkü USER Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study Mediterranean Journal of Infection, Microbes and Antimicrobials chronic hepatitis b hepatitis b e antigen treatment cessation |
| title | Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study |
| title_full | Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study |
| title_fullStr | Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study |
| title_full_unstemmed | Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study |
| title_short | Nucleos(t)ide Analogue Treatment Cessation in Hepatitis B e Antigen-negative Chronic Hepatitis B Patients: A Retrospective Single-center Study |
| title_sort | nucleos t ide analogue treatment cessation in hepatitis b e antigen negative chronic hepatitis b patients a retrospective single center study |
| topic | chronic hepatitis b hepatitis b e antigen treatment cessation |
| url | http://mjima.org/abstract.php?id=216 |
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