Turkish Journal of Gastroenterology
Original Article

Discontinuation of Nucleos(t)ide Analog treatment in HBeAg-Negative Non-Cirrhotic Chronic Hepatitis B Patients: Real-Life Data of 20 Years

1.

Department of Infectious Disease, İstanbul University–Cerrahpaşa Faculty of Medicine, İstanbul, Turkey

2.

Department of Infectious Disease, İstanbul Training and Research Hospital, İstanbul, Turkey

3.

Department of Public Health, Bakırköy District Health Directorate, İstanbul, Turkey

4.

Department of Internal Medicine, Medistate Hospital İstanbul, İstanbul, Turkey

5.

Department of Infectious Diseases, Medilife Health Group, İstanbul, Turkey

6.

Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey

Turk J Gastroenterol 2023; 34: 1163-1170
DOI: 10.5152/tjg.2023.22823
Read: 855 Downloads: 305 Published: 23 August 2023

Background/Aims: Discontinuation of nucleos(t)ide analog is controversial in HBeAg-negative chronic hepatitis B patients not achieved HBsAg loss. We aimed to evaluate re-treatment rates and risk factors in non-cirrhotic HbeAg-negative chronic hepatitis B patients for whom nucleosi(t)ides analogs were discontinued.

Materials and Methods: Demographic, clinical, and laboratory data before and at the end after discontinuation of nucleos(t)ide analogs were collected retrospectively.

Results: Seventy-two patients followed up between January 2000 and December 2019 were included; 43 were male, with a mean age of 46.3 (±10.8). Baseline median alanine aminotransferase (ALT) and hepatitis B virus DNA levels were 55.5 IU/L and 465 925 IU/mL, respectively. The median histologic activity index was 5.5 and the fibrosis score was 2. The median duration of treatment and consolidation therapy were 59 and 56 months, respectively. The median follow-up time after discontinuation of treatment was 55 months. Among 56 patients eligible for evaluation according to proposed re-treatment criteria, 29 (51.7%) patients were re-treated. The median time for relapse was 11 months. Re-treatment was significantly common in males (P = .034) and patients treated with tenofovir/entecavir (P = .04). Baseline hepatitis B virus DNA and levels of ALT, aspartate aminotransferase (AST) at the third and sixth months of treatment and at the end of treatment were statistically significantly higher in re-treated patients. A cutoff value of ≥405 000 IU/L for hepatitis B virus DNA discriminated patients for re-treatment. HBsAg was lost permanently in 2 non-re-treated patients.

Conclusion: In resource-limited areas where follow-up of HBsAg or other markers is not possible, nucleos(t)ide analog discontinuation can be considered in patients in the early stage, with low baseline hepatitis B virus DNA and ALT levels, after a long consolidation therapy.

Cite this article as: Mete B, Yıldız Kaya S, Kaya A, et al. Discontinuation of nucleos(t)ide analog treatment in HBeAg-negative non-cirrhotic chronic hepatitis B patients: Real-life data of 20 years. Turk J Gastroenterol. 2023;34(11):1163-1170.

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