Challenges in the discontinuation of chronic hepatitis B antiviral agents

doi:10.4254/wjh.v13.i9.1042

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Sep 27, 2021; 13(9): 1042-1057
Published online Sep 27, 2021. doi: 10.4254/wjh.v13.i9.1042

Challenges in the discontinuation of chronic hepatitis B antiviral agents

Apichat Kaewdech, Pimsiri Sripongpun

Apichat Kaewdech, Pimsiri Sripongpun, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand

Author contributions: Kaewdech A and Sripongpun P made a substantial contribution to the review concept and drafting of the manuscript; Sripongpun P made a critical revision of the manuscript; All authors approved the final manuscript.

Conflict-of-interest statement: The authors declare that they have no conflicting interests.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Pimsiri Sripongpun, MD, Assistant Professor, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, 15 Kanchanavanich Road, Hat Yai 90110, Songkhla, Thailand. spimsiri@medicine.psu.ac.th

Received: February 21, 2021
Peer-review started: February 21, 2021
First decision: May 3, 2021
Revised: May 7, 2021
Accepted: July 28, 2021
Article in press: July 28, 2021
Published online: September 27, 2021

Core Tip

Core Tip: Stop strategy is one of the options to get closer to functional cure with a finite duration of treatment in chronic hepatitis B patients. Virological relapse and clinical relapse are common after stopping antiviral agent. Half the patients with clinical relapse require retreatment. Novel biomarkers and the SCALE-B score predict clinical relapse and hepatitis B surface antigen clearance. Knowing when to restart treatment and novel sensitive biomarkers are unmet needs.