Interruption of nucleos(t)ide analogue therapy in HBeAg negative chronic hepatitis B – A new concept to achieve HBsAg decline?

Siederdissen, Christoph Höner zu; Deterding, Katja; Port, Kerstin; Maasoumy, Benjamin; Markova, AA; Michael, MP; Wedemeyer, Heiner; Cornberg, Markus

doi:10.1055/s-0034-1397238

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“…There have been new ideas put forward by several European and American studies on flare hepatitis B due to the cessation of NAs which resulted in immune reactivation of patients, and potentially lower quantitative HBsAg titers lower than before NAs were discontinued (Siederdissen, 2015). This is indicated by the high expression of programmed cell death-1 (PD-1) in patients with VHB infection resulting in impaired function and number of cluster of differentiation (CD8) cells, which play an important role in intracellular immunity.…”

Section: Why Is Nucleoside Analog Therapy Stopped?mentioning

confidence: 99%

Termination of Antiviral Administration in Chronic Hepatitis B

Putera

Nusi

Setiawan

et al. 2017

Proceedings of Surabaya International Physiology Seminar

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Virus Hepatitis B (VHB) eradication still cannot be achieved under current clinical guidelines due to the typical virus life cycle. Four phases of disease in chronic hepatitis B infection have been used as guidance in preparing therapy indications. Virus suppression with a nucleoside analog (NA) is an important part of chronic hepatitis B therapy, but the high post-termination recurrence rate of NA results in an unlimited duration of therapy. Long-term NA therapy results in various problems such as resistance, reduced adherence, side-effects, and economic burden for patients. The latest findings add to the possibility of larger HBsAg seroconversion after the termination of NA therapy. Various guidelines provide guidance on the termination of NA therapy. It is stated that the termination of NA therapy can be performed using strict surveillance methods for individuals who have undergone antiretroviral therapy after which follows HBeAg seroconversion, minimal amount of VHB DNA, non-cirrhosis status, and normal ALT levels.

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Section: Why Is Nucleoside Analog Therapy Stopped?mentioning

confidence: 99%