title: [Is it possible to stop treatment with nucleos(t)ide analogs in patients with e-antigen negative chronic hepatitis B? Experience and new expectations].
abstract: BACKGROUND
  Treatment of HBeAg-negative chronic hepatitis B (CHB) with nucleos(t)ide analogues (NA) is usually indefinite, since the loss of HBsAg, as a criterion for its discontinuation, is a rare event. Recent evidence suggests that discontinuing NA therapy may be feasible in selected patients.
  
  
  OBJECTIVE
  To analyze the rate of virological relapse in patients with HBeAg-negative CHB who discontinued treatment with NAs.
  
  
  METHODS
  We performed a single-center observational study that included 140 patients with HBsAg-negative CHB. Twenty-two patients, who received only NAs, discontinued treatment for different reasons and were subsequently monitored. All had normal ALT and AST, undetectable DNA and absence of cirrhosis or significant comorbidities before stopping treatment.
  
  
  RESULTS
  Twelve patients showed virologic relapse (54.54%). The mean interval between discontinuation and relapse was 6.38 months (± 1.9) (75% relapsed during the first 12 months after discontinuation). Five received adefovir, 1 lamivudine and adefovir, 1 tenofovir and 5 lamivudine alone. The mean treatment duration in this group was 38.5 months (± 4.5). The sustained response group had a higher mean age and longer treatment duration than patients with virologic relapse but these differences were not statistically significant.
  
  
  CONCLUSIONS
  The results suggest that NA treatment can be stopped in selected patients with CHB as long as they are not cirrhotic, have completed a minimum period of treatment, have normal ALT and sustained undetectable DNA. These patients should be closely monitored during the first year and then indefinitely.
authors: Servicio de gastroenterología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España. Electronic address: rosam.martinma@salud.madrid.org.
authors: Rosa M
authors: RM
authors: Martín Mateos
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España; Departamento de medicina. Universidad de Alcalá, Madrid, España.
authors: Víctor F
authors: VF
authors: Moreira Vicente
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Eduardo
authors: E
authors: Tavío Hernández
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Jose Luis
authors: JL
authors: Cuño Roldán
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Luis
authors: L
authors: Téllez Villajos
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Marta
authors: M
authors: Aicart Ramos
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Julia
authors: J
authors: Arribas Anta
authors: Servicio de gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España.
authors: Celia
authors: C
authors: Zaera de la Fuente
authors: Servicio de gastroenterología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, España; Departamento de medicina. Universidad de Alcalá, Madrid, España; CIBERehd, Instituto de Salud Carlos III, Madrid, España.
authors: Agustín
authors: A
authors: Albillos Martínez
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D004279:DNA, Viral / Q000302:isolation & purification; D004359:Drug Therapy, Combination; D005260:Female; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009711:Nucleotides / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D009711:Nucleotides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Antivirales orales; HBeAg-negative chronic hepatitis B; Hepatitis crónica B; Nucleos(t)ide analogues; Rebote virológico; virological relapse