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KMID : 0614620160670010028
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Korean Journal of Gastroenterology
2016 Volume.67 No. 1 p.28 ~ p.34
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Predictive Factors for Sustained Remission after Discontinuation of Antiviral Therapy in Patients with HBeAg-positive Chronic Hepatitis B
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전백규:Jun Baek-Gyu
이세환:Lee Sae-Hwan/김홍수:Kim Hong-Soo/김상균:Kim Sang-Gyune/김영석:Kim Young-Seok/김부성:Kim Boo-Sung/정승원:Jeong Soung-Won/장재영:Jang Jae-Young/김영돈:Kim Young-Don/천갑진:Cheon Gab-Jin
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Abstract
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Background/Aims: The optimal timing for discontinuing oral antiviral therapy in patients with HBeAg-positive chronic hepatitis B (CHB) is unclear. The aim of our study was to investigate sustained remission after stopping antiviral therapy in patients with HBeAg-positive CHB.
Methods: We analyzed the medical records of 58 patients who were HBeAg-positive and had discontinued antiviral therapy. Antiviral therapy was discontinued after HBeAg seroconversion and HBV DNA negativity for 6-12 months with consolidation therapy. Virologic relapse was defined as an increase in serum HBV DNA >2,000 IU/mL.
Results: No difference was observed between the virologic non-relapse and virologic relapse groups in baseline HBV DNA level (p=0.441) or duration of seroconversion (p=0.070). Time-to-undetectable HBV DNA during treatment was shorter in the virologic non-relapse group (29 patients) compared to the relapse group (29 patients) (4.9±2.6 vs. 13.2±12.7 months; p<0.01). Cumulative relapse rates were 12.7 in month 3, 32.7 in month 6, 47.3 in month 12, and 52.7% in month 18. We determined by multivariate analysis that the consolidation period (≥18 months, p=0.020) and early virologic response (HBV DNA <20 IU/mL) at six months during antiviral therapy (p=0.017) were significant predictors for sustained remission.
Conclusions: A consolidation period of at least 18 months and early virological response at six months during antiviral therapy were associated with sustained remission in patients with HBeAg-positive CHB after treatment.
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KEYWORD
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Treatment, Chronic hepatitis B, Discontinuation, Remission, Relapse
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