Introduction
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The 2022 European Association for the Study of the Liver (EASL 2022) will be held in London, UK from June 22 to 26. This article reports a study from Taiwanese scholars in my country evaluating the long-term outcomes of patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) after discontinuation of antiviral therapy. Results showed: At the end of follow-up, 49.6% of patients achieved hepatitis B surface antigen (HBsAg) <100 IU/ml, and 16.2% of patients achieved HBsAg clearance .
Long-term outcome assessment after discontinuation of antiviral therapy in HBeAg-negative CHB patients
< p>(Abstract number: SAT438)
Research background span>
Previously, researchers have evaluated 691 HBeAg-negative CHB patients who discontinued nucleoside (acid) analog (NUC) therapy, and the median follow-up The time is about 3 years. Follow-up is now extended to a median of 6.6 years (Q1-Q3: 5-8.2) and the long-term outcomes of these patients are assessed.
Research Methods
This is an observational cohort study in which investigators followed 691 HBeAg-negative CHB patients through December 2021. Virological relapse (VR) was defined as HBV DNA >2000 IU/ml, and clinical relapse (CR) was defined as VR plus alanine aminotransferase (ALT) >2 x ULN. Retreatment was determined according to Taiwan reimbursement criteria: cirrhosis with detectable HBV DNA or non-cirrhotic with CR lasting more than 3 months or CR with serum bilirubin level >2 mg/dL or international normalized ratio (INR) > 1.5 or through joint doctor/patient discussion.
According to clinical outcomes and management methods, the patients were divided into 4 groups: group A without CR and no retreatment; group B without CR but without retreatment Received re-treatment; group C developed CR but did not receive re-treatment; group D developed CR and received re-treatment.
Findings
During a median follow-up of 6.6 years, 180 patients were assigned to Group A (26%), 27 to Group B (4%), 103 to Group C (15%), and 381 to Group D (55%) . Cumulative VR, CR, and retreatment rates are shown in Table 1.
Table 1 Summary of cumulative events in 691 HBeAg-negative CHB patients
The annual decrease in HBsAg in groups A-D were: -0.304, -0.144, -0.277 and -0.205 log< /span>10 IU/ml. At the end of follow-up, 343 (49.6%) of 691 patients achieved HBsAg <100 IU/ml (72.8%, 38.5%, 56.3% and 37.8% in groups A-D, respectively), and 112 (16.2%) achieved HBsAg clearance. They were: group A: 27%, 57%; group B: 0%, 6%; group C: 13%, 38%; group D: 3%, 11%.
In the retreatment group (N=407), 251 patients (61.7%) completed finite therapy, 10 years The cumulative HBsAg clearance rate was 15%, which was higher than in patients who were still on treatment (6%). The incidence of hepatocellular carcinoma (HCC) and liver-related death is very low, mainly in patients with cirrhosis.
Study Conclusions
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Limited therapy did substantially improve functional cure rates, especially in untreated patients. HBsAg clearance accelerated with follow-up time, especially after year 3.
References RWJ, Liu YC, Peng CW, et al. Long-term outcomes after cessation of antiviral therapy in HBeAg negative patients. EASL 2022. Abrasts SAT438.
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