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Nucleotide Analogue Therapy Can Be Terminated in Noncirrhotic CHB Patients, Study Reveals

A recent study has revealed that termination of nucleotide analogue (NA) therapy is feasible in noncirrhotic patients negative for the hepatitis B e-antigen (HBeAg). Particularly, those with low baseline HB surface antigen levels see better results after NA withdrawal.

Photo: Chronic Hepatitis B (CHB) | InStyleHealth

Research involved 27 HBeAg-negative chronic hepatitis B patients without cirrhosis. All patients achieved complete viral suppression for >3years and were subsequently taken off of NA therapy. Serum samples and measurements were performed at baseline and at 3, 6, 12, 18, and 24 months. A functional cure and virological control were the primary efficacy endpoints of this research.

There were 22 of the 27 patients remained off-therapy after an average follow-up of 34 months. With these, there were 8 or 30% of the total study, achieved functional cure, with an average median time to HBsAg clearance of 25 weeks. However, 5 of these 8 cured patients also showed detectable levels of anti-HB antibodies.

For those patients who had achieved functional cure had lower HBsAg levels at baseline; particularly, concentrations tended to be <1,000 IU/mL in these participants. Sequentially, baseline HBsAg was also associated with intrahepatic viral RNA and DNA, the levels of which were suppressed in patients who were functionally cured.

Furthermore, a higher baseline frequency of CD8+ T cells against the virus was correlated with better viral control off-treatment.

Researchers said that NA therapy can be discontinued in a high proportion of CHB patients without cirrhosis. Their comprehensive study provides in-depth data on virological and immunological factors that can help guide individualized therapy in patients with CHB.


Source: J Hepatol 2021

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