2024-03-28T22:22:24Zhttp://digital.csic.es/dspace-oai/requestoai:digital.csic.es:10261/2134152021-03-10T12:13:40Zcom_10261_11773com_10261_1col_10261_11774
http://hdl.handle.net/10261/213415
10.1097/MEG.0000000000001289
394153
Hepatitis B surface antigen loss after discontinuing nucleos(t)ide analogue for treatment of chronic hepatitis B patients is persistent in White patients
Lippincott Williams & Wilkins
2019
artículo
Suárez, Emilio
Buti, María
Rodríguez, Manuel
Prieto, Martín
Pascasio, Juan Manuel
Casanovas, Teresa
Crespo García, Javier
Tapiador, Juan Arenas Ruiz
Gómez-Rodríguez, Rafael
Figueruela, Blanca
Diago, Moisés
Morillas, Rosa María
Zozaya, José Manuel
Calleja, José Luis
Casado, Marta
rp11441
Molina, Esther
Fuentes, Javier
Simón, Miguel Ángel
Chronic hepatitis B
Hepatitis B surface antigen
Hepatitis B virus reactivation
Hepatocellular carcinoma
Nucleos(t)ide analogue treatment
2019-02
[Objective]: The objective of this study was to determine the long-term clinical outcome and persistence of hepatitis B surface antigen (HBsAg) loss after discontinuation of treatment.
[Background]: The prognosis of patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs) who discontinue treatment after loss of HBsAg remains largely unknown, particularly in White patients.
[Patients and methods]: We analysed a cohort of patients with CHB who discontinued NA treatment after loss of HBsAg. A total of 69 patients with hepatitis-B-e antigen-positive or hepatitis-B-e antigen-negative CHB with undetectable HBsAg during NA treatment were included after discontinuation of treatment, and followed up for a median period of 37.8 months (interquartile range: 23.8–54.6 months).
[Results]: At the end of follow-up, none of the patients showed spontaneous reappearance of HBsAg and only one patient had detectable hepatitis B virus DNA (22 IU/ml). Another patient negative for HBsAg and anti-HBs developed hepatitis B virus reactivation without elevated transaminases after treatment with corticosteroids and vincristine for dendritic cell neoplasm, 38 months after withdrawal of the antiviral treatment. Regarding clinical outcome, a patient with cirrhosis developed hepatocellular carcinoma, 6.6 years after discontinuing treatment. None of the patients had hepatic decompensation or underwent liver transplantation.
[Conclusion]: HBsAg clearance after discontinuing NAs in patients with CHB is persistent and associated with good prognosis. The risk for developing hepatocellular carcinoma persists among patients with cirrhosis.
European Journal of Gastroenterology and Hepatology
2019
31
267
271