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ORIGINAL ARTICLES  
CMH 2013 September;19:300-304.
Published online 2013 September 29. doi:http://dx.doi.org/10.3350/cmh.2013.19.3.300
Copyright © 2013 The Korean Association for the Study of the Liver
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Durability after discontinuation of nucleos(t)ide therapy in chronic HBeAg negative hepatitis patients
Young Jip Kim, Kichan Kim, Sun Hyuk Hwang, Soon Sun Kim, Dami Lee, Jae Youn Cheong, and Sung Won Cho
Department of Gastroenterology, Ajou Universitiy School of Medicine, Suwon, Korea
Corresponding Author: Sung Won Cho ,Tel: +82-31-219-6939, Fax: +82-31-219-5999, Email: sung_woncho@hotmail.com
ABSTRACT
Background/Aims: Relapse has been reported after stopping nucleos(t)ide (NUC) therapy in the majority of chronic HBeAg negative hepatitis patients. However, the ideal treatment duration of HBeAg negative chronic hepatitis B (CHB) is not well known. We investigated the frequency of relapse in HBeAg negative CHB patients receiving NUC therapy.
Methods: The NUC therapy was discontinued at least 3 times undetectable level of HBV DNA leave 6 months space in 45 patients. Clinical relapse was defined as HBV DNA >2,000 IU/mL and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2 times of upper limit of normal range. Virological relapse was defined as HBV DNA >2,000 IU/mL.
Results: Clinical relapse developed in 16 (35.6%) and 24 (53.3%) patients after stopping therapy at 6 months and 12 months off therapy, respectively. Virological relapse developed 22 (48.9%) and 33 (73.3%) patients at 6 months and 12 months off therapy. The factors such as age, gender, cirrhosis, baseline AST, ALT, HBV DNA levels, treatment duration, and consolidation duration were analyzed to investigate the predictive factors associated with 1 year sustained response. Of these factors, cirrhosis (86.1% in CHB, 22.2% in LC) was significantly associated with 1 year virological relapse rate. Baseline HBV DNA and total treatment duration tended to be associated with virological relapse.
Conclusions: Virological relapse developed in the majority (73.3%) of HBeAg negative CHB patients and clinical relapse developed in the half (53.3%) of patients at 1 year off therapy. Cirrhosis may be associated with the low rate of virological relapse.
Keywords: Chronic hepatitis B; Durability; Nucleos(t)ide analogue
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