Role of serum HBV RNA and hepatitis B surface antigen levels in identifying Asian patients with chronic hepatitis B suitable for entecavir cessation
- 5 August 2020
- Vol. 70 (4), 775-783
- https://doi.org/10.1136/gutjnl-2020-321116
Abstract
Background Treatment cessation in chronic HBV infection may be durable in certain patient subgroups before hepatitis B surface antigen (HBsAg) seroclearance. The role of serum HBV RNA in determining treatment cessation suitability has not been well-investigated. Methods Nucleos(t)ide analogue (NUC) treatment was discontinued in non-cirrhotic patients with chronic HBV with serum HBsAg 2000 IU/mL regardless of alanine aminotransferase (ALT) levels. Results 114 entecavir-treated patients (median age 58.4 years, median serum HBsAg 54.4 IU/mL) with median treatment duration of 6.7 years were recruited. The 48-week cumulative rate of HBV DNA >2000 IU/mL was 58.1%. End-of-treatment serum HBV RNA and off-treatment serial HBV RNA were both independently associated with HBV DNA >2000 IU/mL (HR 2.959, 95% CI 1.776 to 4.926, pConclusion Serum HBV RNA measurement is essential for deciding on entecavir cessation in patients with chronic HBV, especially with low HBsAg levels. Patients can be stratified on their risk of off-treatment relapse based on both viral determinants. Trial registration number NCT02738554Keywords
Funding Information
- Innovative Research Fund, State Key Laboratory of Liver Research, The University of Hong Kong (SKLLR/IRF/2018/07)
- SK Yee Medical Foundation Grant (2141213)
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