Published online Apr 14, 2021. doi: 10.3748/wjg.v27.i14.1497
Peer-review started: January 14, 2021
First decision: February 10, 2021
Revised: February 21, 2021
Accepted: March 17, 2021
Article in press: March 17, 2021
Published online: April 14, 2021
Nucleos(t)ide analogs (NAs) cessation in chronic hepatitis B (CHB) patients remains a matter of debate in clinical practice, especially in patients who fail to achieve hepatitis B e antigen (HBeAg) seroconversion after the long-term loss of HBeAg. Few studies were explicitly designed for this subpopulation.
To determine whether chronic hepatitis B patients with HBeAg loss could discontinue NAs after long-term consolidation.
We investigated the outcomes and factors associated with HBeAg-positive CHB patients with HBeAg loss [without hepatitis B e antibody (HBeAb)] after cessation of NAs.
Patients who discontinued NAs after achieving HBeAg loss (without HBeAb) for long periods were included and predictive factors were explored. CHB patients who achieved HBeAg seroconversion were also included for controls.
HBeAg-positive CHB patients with HBeAg loss maintained acceptable virological response after NAs cessation, especially in patients with hepatitis B surface antigen (HBsAg) at cessation < 100 IU/mL. After PSM, the cumulative relapse rates were higher than those in patients with HBeAg seroconversion. More extended consolidation periods (≥ 24 mo) and low HBsAg at cessation (< 100 IU/mL) predicted better response after NAs cessation.
HBeAg-positive CHB patients with HBeAg loss may be able to discontinue NAs therapy after long-term consolidation, especially in patients with HBsAg at cessation < 100 IU/mL.
HBeAg-positive CHB patients with HBeAg loss may be able to discontinue NAs therapy after long-term consolidation and lower HBsAg at cessation is preferred. Careful monitoring, especially in the early stages after cessation, may ensure a favorable outcome.