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Why not to stop antiviral treatment in patients with chronic hepatitis B
Author(s) -
Marciano Sebastián,
Gadano Adrián
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13627
Subject(s) - discontinuation , medicine , entecavir , decompensation , antiviral treatment , cirrhosis , chronic hepatitis , jaundice , gastroenterology , tenofovir , hepatitis b , immunology , virus , lamivudine , human immunodeficiency virus (hiv)
Treatment of chronic hepatitis B with entecavir or tenofovir leads to viral suppression in almost all patients. However, prolonged or lifelong treatment is necessary. At present, there is no consensus among the three major guidelines for the treatment of chronic hepatitis B on whether or not to stop antiviral treatment. One of the main reasons for this controversy is that virological relapse has been well documented in patients with chronic hepatitis B who stop treatment. Relapse rate is particularly high in patients who are HB eAg‐negative when treatment begins, with reported relapse rates of up to 70% 36 months after treatment discontinuation. Moreover, hepatic decompensation, jaundice and death have been described in patients with cirrhosis after treatment discontinuation. The main reason for stopping antiviral treatment is related to cost, however there is no robust evidence to support treatment discontinuation in most patients.