Liver and Bile
Dig Liver Dis. 2023;55(9):1223–9
Posttreatment HBsAg decline predicts high rate of HBsAg loss after stopping entecavir or tenofovir in HBeAg-negative patients without retreatment
Background and aims: Little is known about the role of posttreatment hepatitis B surface antigen (HBsAg) decline in HBsAg loss following nucleos(t)ide analogues cessation.
Methods: Hepatitis B e antigen (HBeAg)-negative patients without cirrhosis who previously received entecavir or tenofovir disoproxil fumarate were enrolled (n = 530). All patients were followed-up posttreatment for > 24 months.
Results: Of the 530 patients, 126 achieved sustained response (Group I), 85 experienced virological relapse without clinical relapse and retreatment (Group II), 67 suffered clinical relapse without retreatment (Group III) and 252 received retreatment (Group IV). The cumulative incidence of HBsAg loss at 8 years was 57.3% in Group I, 24.1% in Group II, 35.9% in Group III and 7.3% in Group IV. Cox regression analysis showed that nucleos(t)ide analogue experience, lower HBsAg levels at end-of-treatment (EOT) and higher HBsAg decline at 6 months after EOT were independently associated with HBsAg loss in Group I and Groups II + III. The rates of HBsAg loss at 6 years in patients with HBsAg decline > 0.2 log IU/ml in Group I and HBsAg decline > 0.15 log IU/ml in Group II + III at 6 months after EOT were 87.7% and 47.1%, respectively.
Conclusion: The hepatitis B surface antigen (HBsAg) loss rate was high and posttreatment HBsAg decline could predict high HBsAg loss rate among hepatitis B e antigen-negative patients who discontinued entecavir or tenofovir disoproxil fumarate and did not need retreatment.