Discontinuation of antiviral therapy in chronic hepatitis B patients

作     者：Renato Medas Rodrigo Liberal Guilherme Macedo 

作者机构：Department of Gastroenterology and HepatologyCentro Hospitalar Universitario de São JoãoPorto 4200-319Portugal 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2021年第9卷第24期

页      面：6979-6986页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Chronic hepatitis B Finite therapy Hepatitis B surface antigen loss Relapse Retreatment 

摘      要：Nucleos(t)ide analogs(NUC)are the first-line therapy for patients with chronic hepatitis B(CHB)recommended by most current *** therapy decreases progression of liver disease,reduces the risk of liver-related complications,and improves the quality of life of patients with *** 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 *** data showed the feasibility,efficacy,and safety of stopping antiviral therapy in carefully selected CHB patients,leading to its incorporation in international *** who discontinue NUC have a higher likelihood of hepatitis B surface antigen(HBsAg)loss compared to patients who continue on *** pertaining endpoints allowing safety discontinuation of NUC therapy differ among international *** hepatitis B e antigen(HBeAg)-positive patients,durable HBeAg seroconversion is considered an acceptable treatment *** 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 *** patients who stop therapy should remain under strict clinical and laboratorial follow-up protocols to detect and manage relapses in a timely *** 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.