studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1193A
2019
Discontinuation of Effective Long-Term Nucleos(t)ide
Analogue(s) [NA(s)] Treatment in HBeAg-Negative
Chronic Hepatitis B (CHBe-) Patients: A Multicenter
Ongoing Prospective Study
Spilios Manolakopoulos 1 , Hariklia Kranidioti 1 , Anastasia
Kourikou 1 , Emilia Hadziyannis 1 , Georgios Kontos 1 , Melanie
Deutsch 1 , Alexandra Alexopoulou 1 , Emanuel K. Manesis 1 , George
V. Papatheodoridis 2,1 ; 1 2nd Department of Internal Medicine, University
of Athens, Hippokration General Hospital, Athens, Greece;
2 Department of Gastroenterology, University of Athens, Laiko General
Hospital, Athens, Greece
Background/Aim The durability of response to NA(s) after
their cessation, has not been adequately investigated in
CHBe- patients. This prospective study aims to investigate the
outcome of CHBe- patients who discontinue NA(s) after longterm
virological suppression and to explore factors that may
predict relapse. Methods Non-cirrhotic CHBe- patients with
virological remission (undetectable HBV-DNA) under NA(s)
for ≥4 years who could remain under close follow-up (every
month for the first 3 months and every 3 months thereafter)
were invited to consent to treatment discontinuation. Τhe criteria
for NA(s) retreatment were: ALT>2xULN & Bilirubin>2mg/
dl, ALT>10xULN, ALT>5xULN in 2 monthly determinations,
ALT>3xULN and HBV-DNA>100,000IU/mL, ALT>ULN & HBV-
DNA>2,000IU/mL for ≥6 months. Results Until May 2015,
43 patients [males: 74%, median age: 60 (22-86) ys, duration
of NA(s): 7.9 (4-14) ys] had >6 months follow-up [median: 27
(6-45) months] and were included in the analysis. Off-treatment
virological relapse (HBV-DNA >2000IU/mL) was developed
in 40 (93%) and biochemical relapse (ALT >ULN) in 29 (67%)
patients. Ten patients (23%) experienced hepatitis flare (ALT
>10 ULN) at a median of 3 (1-9) months after NA(s) discontinuation,
without evidence of liver decompensation. Retreatment
was required in 18 (42%) patients at a median of 6.5 (1-33)
months. Of the 25 patients who remained untreated, 14 (56%)
had ALT persistently