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Cited 11 time in webofscience Cited 15 time in scopus
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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
Kim, Minseok AlbertKim, Seung UpSinn, Dong HyunJang, Jeong WonLim, Young-SukAhn, Sang HoonShim, Jae-JunSeo, Yeon SeokBaek, Yang HyunKim, Sang GyuneKim, Young SeokKim, Ji HoonChoe, Won HyeokYim, Hyung JoonLee, Hyun WoongKwon, Jung HyunLee, Sung WonJang, Jae YoungKim, Hwi YoungPark, YewanKim, Gi-AeYang, HyunLee, Han AhKoh, MyeongseokLee, Young-SunKim, MinkooChang, YoungKim, Yoon JunYoon, Jung-HwanZoulim, FabienLee, Jeong-Hoon
Issue Date
Dec-2020
Publisher
BMJ Publishing Group
Keywords
antivirals; HBsAg; HBV DNA redetection; hepatocellular carcinoma
Citation
Gut, v.69, no.12, pp.2214 - 2222
Indexed
SCIE
SCOPUS
Journal Title
Gut
Volume
69
Number
12
Start Page
2214
End Page
2222
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/49204
DOI
10.1136/gutjnl-2019-320015
ISSN
0017-5749
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.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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