When to stop nucleos(t)ide analogues treatment for chronic hepatitis B? Durability of antiviral response

作     者：Wonseok Kang Jun Yong Park 

作者机构：Department of Internal MedicineInstitute of GastroenterologyYonsei University College of MedicineSeoul 120-752South Korea Liver Cirrhosis Clinical Research CenterSeoul 120-752South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第23期

页      面：7207-7212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)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by Liver Cirrhosis Clinical Research Center in part by a grant from the Korea Healthcare Technology R and D project,Ministry of Health and Welfare,Republic of Korea No.HI10C2020 

主　　题：Chronic hepatitis B Antiviral therapy Nucleos(t)ide analogue Durability Cessation 

摘      要：Introduction of nucleos(t)ide analogues(NAs)for oral antiviral therapy has dramatically improved the clinical outcome in patients with chronic hepatitis B(CHB).Although current international guidelines for the management of CHB provide information regarding when to begin the antiviral therapy with NAs,there is no clear consensus on when to stop the treatment,especially for those who respond to the *** B surface antigen loss has been regarded as an ideal endpoint of oral antiviral therapy with NAs,however since this is rarely achieved,practical endpoints have been suggested by the international *** the stopping rules recommended by the international guidelines,whether oral antiviral therapy with NAs can be safely discontinued is of major *** attention has been drawn to whether antiviral treatment with NAs can be a finite therapy,there is lack of sufficient data on off-treatment durability of highly potent *** on the available evidences,current guidelines for stopping NA therapy seems to be inadequate in terms of off-treatment durability,with relapse rates of more than 40%for both hepatitis Be antigen(HBeAg)-positive and HBeAg-negative ***,further studies are required to accumulate data on off-treatment durability of highly potent NAs,and future studies are warranted to identify adequate predictive markers that could provide supplementary information to guide the timing of stopping NA therapy.