title: Off-treatment durability of antiviral response to nucleoside analogues in patients with chronic hepatitis B.
abstract: BACKGROUND
  Off-treatment durability of nucleoside analogue (NA) therapy in patients with chronic hepatitis B has not been well investigated. In this study we monitored antiviral effect of NA therapy and evaluated off-treatment durability after NA cessation in patients with chronic hepatitis B.
  
  
  METHODS
  A total of 94 consecutive patients (39 HBeAg-negative and 55 HBeAg-positive patients) who received NA therapy were followed up for approximately 9 years. We discontinued NA according to the following criteria; undetectable serum HBV-DNA by polymerase chain reaction (PCR) on three separate occasions at least 6 months apart in HBeAg-negative patients (APASL stopping recommendation), and seroconversion from HBeAg-positive to HBeAb-positive and undetectable serum HBV-DNA by PCR for at least 12 months in HBeAg-positive patients.
  
  
  RESULTS
  The cumulative rate of relapse after NA cessation was 48 % and 40 % in HBeAg-negative and -positive patients, respectively. Higher baseline serum alanine aminotransferase level was the only significant predictor for maintaining remission. No patients experienced decompensation after relapse. HBsAg loss occurred at an annual rate of 1.4 % and 0.4 % in HBeAg-negative and -positive patients, respectively. Hepatocellular carcinoma developed at an annual rate of 0.6 % in both HBeAg-negative and -positive patients.
  
  
  CONCLUSIONS
  Almost half of the patients did not relapse after cessation of NA therapy in both HBeAg-negative and -positive patients. Therefore, NA therapy could be discontinued with close monitoring if the APASL stopping recommendation is satisfied even in HBeAg-negative patients.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Nagata
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan. kagawa@tokai.ac.jp.
authors.forename: Tatehiro
authors.initials: T
authors.lastname: Kagawa
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Hirose
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Arase
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Tsuruya
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Anzai
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Shiraishi
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara, 259-1193, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000410:Alanine Transaminase
keywords: Chronic hepatitis B; Durability; HBs antigen; Hepatocellular carcinoma; Nucleoside analogue