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Discontinuation of nucleos(t)ide analogues is not associated with a higher risk of HBsAg seroreversion after antiviral-induced HBsAg seroclearance: a nationwide multicentre study

Authors
 Minseok Albert Kim  ;  Seung Up Kim  ;  Dong Hyun Sinn  ;  Jeong Won Jang  ;  Young-Suk Lim  ;  Sang Hoon Ahn  ;  Jae-Jun Shim  ;  Yeon Seok Seo  ;  Yang Hyun Baek  ;  Sang Gyune Kim  ;  Young Seok Kim  ;  Ji Hoon Kim  ;  Won Hyeok Choe  ;  Hyung Joon Yim  ;  Hyun Woong Lee  ;  Jung Hyun Kwon  ;  Sung Won Lee  ;  Jae Young Jang  ;  Hwi Young Kim  ;  Yewan Park  ;  Gi-Ae Kim  ;  Hyun Yang  ;  Han Ah Lee  ;  Myeongseok Koh  ;  Young-Sun Lee  ;  Minkoo Kim  ;  Young Chang  ;  Yoon Jun Kim  ;  Jung-Hwan Yoon  ;  Fabien Zoulim  ;  Jeong-Hoon Lee 
Citation
 GUT, Vol.69(12) : 2214-2222, 2020-12 
Journal Title
 GUT 
ISSN
 0017-5749 
Issue Date
2020-12
Keywords
HBV DNA redetection ; HBsAg ; antivirals ; hepatocellular carcinoma
Abstract
Objective: Direct comparison of the clinical outcomes between nucleos(t)ide analogue (NA) discontinuation versus NA continuation has not been performed in patients with chronic hepatitis B who achieved HBsAg-seroclearance. Whether NA discontinuation was as safe as NA continuation after NA-induced surface antigen of HBV (HBsAg) seroclearance was investigated in the present study. Designs: This multicentre study included 276 patients from 16 hospitals in Korea who achieved NA-induced HBsAg seroclearance: 131 (47.5%) discontinued NA treatment within 6 months after HBsAg seroclearance (NA discontinuation group) and 145 (52.5%) continued NA treatment (NA continuation group). Primary endpoint was HBsAg reversion and secondary endpoints included serum HBV DNA redetection and development of hepatocellular carcinoma (HCC). Results: During follow-up (median=26.9 months, IQR=12.2-49.2 months), 10 patients (3.6%) experienced HBsAg reversion, 6 (2.2%) showed HBV DNA redetection and 8 (2.9%) developed HCC. Compared with NA continuation, NA discontinuation was not associated with HBsAg reversion in both univariable (HR=0.45, 95% CI=0.12 to 1.76, log-rank p=0.24) and multivariable analyses (adjusted HR=0.65, 95% CI=0.16 to 2.59, p=0.54). The cumulative probabilities of HBsAg reversion at 1, 3 and 5 years were 0.8%, 2.3% and 5.0% in the NA discontinuation group, and 1.5%, 6.3% and 8.4% in the NA continuation group, respectively. NA discontinuation was not associated with higher risk of either HBV redetection (HR=0.83, 95% CI=0.16 to 4.16, log-rank p=0.82) or HCC development (HR=0.53, 95% CI=0.12 to 2.23, log-rank p=0.38). Conclusion: The discontinuation of NA was not associated with a higher risk of either HBsAg reversion, serum HBV DNA redetection or HCC development compared with NA continuation among patients who achieved HBsAg seroclearance with NA.
Full Text
https://gut.bmj.com/content/69/12/2214.long
DOI
10.1136/gutjnl-2019-320015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Hyun Woong(이현웅) ORCID logo https://orcid.org/0000-0002-6958-3035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180685
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