Stopping nucleos(t)ide analog treatment in chronic hepatitis B-Who and when?

作     者：Suzette Grace R.Kho-Herman Henry Lik-Yuen Chan Suzette Grace R.Kho-Herman;Henry Lik-Yuen Chan

作者机构：Institute of Digestive DiseaseThe Chinese University of Hong KongHong KongChina Makati Medical CenterMakatiPhilippines 

出 版 物：《Liver Research》 (肝脏研究（英文）)

年 卷 期：2017年第1卷第2期

页      面：135-139页

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] 

主　　题：Hepatitis B Entecavir Tenofovir Hepatitis B virus deoxyribonucleic acid (HBV DNA) Hepatitis B surface antigen(HBsAg) Hepatitis B core-related antigen(HBcrAg) Hepatitis B e antigen(HBeAg) 

摘      要：Nucleos(t)ide analogs(NAs)are one of the first-line treatments for chronic hepatitis B(CHB)*** are highly efficient in suppressing viral replication but are associated with a low rate of hepatitis B surface antigen(HBsAg)seroclearance and a high risk of post-treatment virologic *** a result,the optimal timing of NA cessation remains unclear,and long-term treatment is often *** international guidelines suggest that NA can be discontinued in hepatitis B e antigen(HBeAg)-positive patients who achieve HBeAg seroconversion with undetectable hepatitis B virus(HBV)DNA levels,the recommendations for discontinuing NA treatment in HBeAg-negative patients remain ***,there is no consensus regarding in whom and when to restart treatment among patients with hepatitis relapse after stopping NA *** studies suggest that virologic markers such as HBsAg and hepatitis B core-related antigen(HBcrAg)titers may be useful to guide when to stop NAs in CHB,since both markers appear to correlate with intrahepatic covalently closed circular HBV DNA ***,additional studies are required to refine their use.