Meet the Experts: Hepatitis B: When to stop NA therapy?

 Viral hepatitis

Stolz 1
English
Meet the Experts
13 April 2019 09:00 - 09:50

Questions for discussion:

HBeAg-positive chronic hepatitis B (CHB)

  • Do you discontinue NA therapy in a non-cirrhotic patient with HBeAg-positive CHB who remains HBsAg positive but achieves HBeAg seroconversion and HBV DNA undetectability for at least 12 months?
  • Do you prolong treatment (eg for 36 months) before discontinuation in all or subgroups of patients who achieve HBeAg seroconversion and HBV DNA undetectability?
  • Do HBsAg serum levels affect the decision for stopping therapy?
  • How do you follow such a patient after stopping therapy?

HBeAg-negative CHB

  • Do you discontinue NA therapy in a non-cirrhotic patient with HBeAg-negative CHB who remains HBsAg positive but achieves HBV DNA undetectability?
  • If yes, which is the minimum duration of on-therapy HBV DNA undetectability before therapy withdrawal?
  • Do HBsAg serum levels affect the decision for stopping therapy?
  • How do you follow such a patient after stopping therapy?
  • Which are the criteria for retreatment?
  • How do you manage a post-treatment ALT flare?

NA: nucleos(t)ide analogue, CHB: chronic hepatitis B