Viral and Host Responses After Stopping Long-term Nucleos(t)ide Analogue Therapy in HBeAg-Negative Chronic Hepatitis B

J Infect Dis. 2016 Nov 15;214(10):1492-1497. doi: 10.1093/infdis/jiw412. Epub 2016 Sep 7.

Abstract

This prospective study investigated viral and host markers after stopping long-term therapy with nucleos(t)ide analogues in noncirrhotic patients with hepatitis B e antigen-negative chronic hepatitis B. After stopping therapy, 13 of 15 patients experienced a virological relapse. Rebound of hepatitis B virus DNA and hepatitis B core-related antigen was associated with induction of plasma tumor necrosis factor, interleukin (IL) 10 , IL-12p70, CXCL10 and subsequent decline in hepatitis B surface antigen (HBsAg), with 20% HBsAg loss after long-term follow-up. The peak levels of hepatitis B virus DNA and hepatitis B core-related antigen after cessation of therapy were positively correlated with the level of HBsAg decline at week 48. Thus, stopping or interrupting NA treatment should be further investigated as a strategy to accelerate HBsAg loss.

Keywords: CXCL10; HBsAg; IP-10; cytokines; hepatitis B virus infection; nucleos(t)ide analogues; stopping treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / administration & dosage*
  • Cytokines / blood
  • DNA, Viral / blood
  • Female
  • Hepatitis B Core Antigens / blood
  • Hepatitis B e Antigens / blood*
  • Hepatitis B, Chronic / drug therapy*
  • Hepatitis B, Chronic / pathology
  • Hepatitis B, Chronic / virology*
  • Humans
  • Male
  • Middle Aged
  • Nucleosides / administration & dosage*
  • Nucleotides / administration & dosage*
  • Prospective Studies
  • Recurrence
  • Withholding Treatment*

Substances

  • Antiviral Agents
  • Cytokines
  • DNA, Viral
  • Hepatitis B Core Antigens
  • Hepatitis B e Antigens
  • Nucleosides
  • Nucleotides