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Nucleoside/nucleotide analog consolidation therapy in hepatitis B e‐antigen positive chronic hepatitis B patients: Three years should be preferred
Author(s) -
Li Tao,
Liang Yan,
Zhang Meng,
Liu Feng,
Zhang Lixin,
Yang Baohua,
Wang Lei
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13641
Subject(s) - medicine , gastroenterology , propensity score matching , hbeag , chronic hepatitis , seroconversion , nucleoside analogue , hepatitis b virus , immunology , nucleoside , virus , hbsag , stereochemistry , chemistry
Aim To assess the role of consolidation therapy after cessation of nucleoside/nucleotide analogs (NAs) for off‐treatment outcome and to explore the optimal consolidation period in hepatitis B e‐antigen (HBeAg) positive chronic hepatitis B (CHB) patients. Methods We undertook a prospective, observational cohort study including HBeAg positive CHB patients discontinuing NAs. Virological relapse was the primary endpoint of the current study and was defined as a serum hepatitis B virus DNA more than 10 4 copies/ml (another assay was carried out for confirmation at least 2 weeks later). Propensity score matching analysis was used to balance the baseline characteristics between HBeAg positive CHB patients with different consolidation periods. Results A total of 190 HBeAg positive CHB patients were included. Fifty‐four patients relapsed during follow‐up and the cumulative relapse rates at years 1, 3, 5, and 10 were 19.5%, 24.1%, 27.2%, and 32.1%, respectively. Most patients (61.1%) relapsed in the first 6 months. After propensity score matching, significantly lower cumulative relapse rates were observed in patients with consolidation period ≥36 months compared with patients with consolidation period more than 36 months (29.3% vs. 52.8% at year 10; p  = 0.012). Conclusions Cessation of NAs after HBeAg seroconversion and long‐term consolidation is generally safe and feasible in HBeAg positive CHB patients. Three years of consolidation should be preferred in clinical practice.

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