title: New therapeutic perspectives in HBV: when to stop NAs.
abstract: The goal of chronic hepatitis B (CHB) treatment is to achieve seroclearance of HBsAg. Nucleos(t)ide analogues (NAs) are one of the first-line treatments for CHB. NAs produce a potent suppression of viral replication but are associated with a low rate of HBsAg seroclearance and a high risk of virological relapse after discontinuation. Because of these reasons, long-term treatment is needed. They are well-tolerated oral drugs, and it seems they do not produce important side-effects in long-term administration. The duration of NA treatment remains unclear, nevertheless, in some patients NAs can be stopped with a low rate of relapse. HBeAg-positive patients could discontinue NA therapy if they achieved HBeAg seroclearance and maintain undetectable HBV DNA. For HBeAg-negative patients, to stop NA treatment is not recommended. In addition to other factors, serum HBsAg titres during treatment have recently been proposed to guide NA-based therapy duration in selected patients. All patients could be stopped from taking treatment if they achieve HBsAg loss.
authors.affiliation: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Pérez-Cameo
authors.forename: Mònica
authors.initials: M
authors.lastname: Pons
authors.forename: Rafael
authors.initials: R
authors.lastname: Esteban
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D004359:Drug Therapy, Combination / Q000379:methods* / Q000639:trends; D006147:Guanine / Q000031:analogs & derivatives; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine; D009705:Nucleosides / Q000627:therapeutic use*; D063065:Organophosphonates; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D000077712:Telbivudine; D000068698:Tenofovir; D013936:Thymidine / Q000031:analogs & derivatives
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009705:Nucleosides; D063065:Organophosphonates; D011994:Recombinant Proteins; D000077712:Telbivudine; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000068698:Tenofovir; C417083:peginterferon alfa-2b; D000225:Adenine; D013936:Thymidine
keywords: chronic hepatitis B; nucleos(t)ide analogues; treatment