Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients

Kyu Sik Jung, Jun Yong Park, Young Eun Chon, Hyon Suk Kim, Wonseok Kang, Beom Kyung Kim, Seung Up Kim, Do Young Kim, Kwang Hyub Han, Sang Hoon Ahn

Research output: Contribution to journalArticlepeer-review

67 Citations (Scopus)


Background: Little is known about stopping rules of nucelos(t)ide analog (NA) treatment for chronic hepatitis B (CHB). Methods: A total of 113 consecutive patients with CHB (45 HBeAg-positive and 68 HBeAg-negative CHB patients), who met the cessation criteria of NA treatment as per the Asian-Pacific Association for the Study of the Liver (APASL) guideline, were enrolled in this prospective cohort study. The primary endpoint was to evaluate virological relapse (VR) rate within 1 year, which was defined as reappearance of hepatitis B virus (HBV)–DNA > 2000 IU/mL after cessation of NA treatment. In this cohort, entecavir was used in 81 (71.7 %) and lamivudine in 32 (28.3 %) patients. Results: Within 1 year after NA treatment, VR occurred in 26 (57.8 %) HBeAg-positive patients and in 37 (54.4 %) HBeAg-negative patients. In univariate and subsequent multivariate analysis, age > 40 years [odds ratio (OR) 10.959; 95 % confidence interval (CI) 2.211–54.320; P = 0.003) and a pre-treatment HBV DNA level >2000,000 IU/mL (OR 9.285; 95 % CI 1.545–55.795; P = 0.036) were identified as independent risk factors for VR in HBeAg-positive patients, and age > 40 years (OR 6.690; 95 % CI 1.314–34.057; P = 0.022) and an end-of-treatment HBcrAg level >3.7 log IU/mL (OR 3.751; 95 % CI 1.187–11.856; P = 0.024) were identified in HBeAg-negative patients. During follow up, neither hepatic decompensation nor hepatocellular carcinoma (HCC) occurred, and HBV DNA suppression was achieved in all patients who received antiviral re-treatment. Conclusion: Our data suggested that the APASL stopping rule could be applied if a candidate was properly selected using individual risk factors. However, regular monitoring should be performed after cessation of NA treatment and long-term outcomes need to be evaluated further.

Original languageEnglish
Pages (from-to)830-839
Number of pages10
JournalJournal of Gastroenterology
Issue number8
Publication statusPublished - 2016 Aug 1

Bibliographical note

Funding Information:
This study was supported by following Grants; (a) a fund of the HBV cohort study from the Korea Centers for Disease Control and Prevention (4800-4845-300-260, 2015-ER5101-00), (b) a faculty research Grant of Yonsei University College of Medicine (No. 6-2012-0008).

Publisher Copyright:
© 2015, Japanese Society of Gastroenterology.

All Science Journal Classification (ASJC) codes

  • Gastroenterology


Dive into the research topics of 'Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients'. Together they form a unique fingerprint.

Cite this