Stopping Antiviral Therapy in Chronic Hepatitis B Virus Infection

In a proof-of-concept study, stopping antiviral therapy in e antigen–negative patients resulted in a significant decline in the surface antigen level, suggesting that immune activation results in infection clearance.

Therapy with antiviral nucleoside and nucleotide analogue inhibitors (NAs) has been demonstrated to delay the progression of liver disease among those with chronic hepatitis B virus (HBV) infection. Among those who have become HBV e antigen–negative (HBeAg−), discontinuation of NAs often results in rebound of viral replication and recurrence of clinically active hepatitis. NAs are currently recommended at least until HBeAg− patients become HBV surface antigen–negative (HBsAg−). However, some evidence suggests that stopping NAs in some HBeAg− patients before clearance of HBsAg results in long-term remission of active infection. This control appears to be due to a heightened immune response when HBV replication recurs.

To examine this phenomen…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Stopping Antiviral Therapy in Chronic Hepatitis B Virus Infection

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Reviewing Author