Predictive Factors for Sustained Remission after Discontinuation of Antiviral Therapy in Patients with HBeAg-positive Chronic Hepatitis B.
- Author:
Baek Gyu JUN
1
;
Sae Hwan LEE
;
Hong Soo KIM
;
Sang Gyune KIM
;
Young Seok KIM
;
Boo Sung KIM
;
Soung Won JEONG
;
Jae Young JANG
;
Young Don KIM
;
Gab Jin CHEON
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Treatment; Chronic hepatitis B; Discontinuation; Remission; Relapse
- MeSH: Adult; Aged; Antiviral Agents/*therapeutic use; DNA, Viral/analysis; Female; Hepatitis B e Antigens/*blood; Hepatitis B virus/genetics/isolation & purification; Hepatitis B, Chronic/*drug therapy; Humans; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Recurrence; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; Withholding Treatment
- From:The Korean Journal of Gastroenterology 2016;67(1):28-34
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The optimal timing for discontinuing oral antiviral therapy in patients with HBeAg-positive chronic hepatitis B (CHB) is unclear. The aim of our study was to investigate sustained remission after stopping antiviral therapy in patients with HBeAg-positive CHB. METHODS: We analyzed the medical records of 58 patients who were HBeAg-positive and had discontinued antiviral therapy. Antiviral therapy was discontinued after HBeAg seroconversion and HBV DNA negativity for 6-12 months with consolidation therapy. Virologic relapse was defined as an increase in serum HBV DNA >2,000 IU/mL. RESULTS: No difference was observed between the virologic non-relapse and virologic relapse groups in baseline HBV DNA level (p=0.441) or duration of seroconversion (p=0.070). Time-to-undetectable HBV DNA during treatment was shorter in the virologic non-relapse group (29 patients) compared to the relapse group (29 patients) (4.9+/-2.6 vs. 13.2+/-12.7 months; p<0.01). Cumulative relapse rates were 12.7 in month 3, 32.7 in month 6, 47.3 in month 12, and 52.7% in month 18. We determined by multivariate analysis that the consolidation period (> or =18 months, p=0.020) and early virologic response (HBV DNA <20 IU/mL) at six months during antiviral therapy (p=0.017) were significant predictors for sustained remission. CONCLUSIONS: A consolidation period of at least 18 months and early virological response at six months during antiviral therapy were associated with sustained remission in patients with HBeAg-positive CHB after treatment.
