Patterns of HBV viremia change and HBsAg loss rate in patients without retreatment within 2 years after entecavir or tenofovir cessation.

Abstract

Objectives: This study investigated the patterns of HBV viremia change and HBsAg loss rate without retreatment within 2 years after nucleos(t)ide analogues (NA) cessation.

Methods: We enrolled 481 patients who did not receive retreatment in the first 2 years after entecavir or tenofovir disoproxil fumarate (TDF) cessation.

Results: Group I was defined as persistent HBV DNA<2000 IU/mL and normal alanine transaminase (ALT)<40 U/mL (inactive phase); Group II and Group III, as HBV DNA>2000 IU/mL and ALT<40 U/L (Group II) or ALT 40‒80 IU/mL (Group III); Group IV), as HBV DNA>2000 IU/mL and ALT>80 U/mL (active phase). Of the 242 Group I patients, 205 (84.7%) remained in the same group and 22 (9.1%) transitioned to active phase beyond the first 2 years. Of the 239 Group II, III and IV patients, 33%, 28.8% and 31.1% patients transitioned to inactive phase beyond the first 2 years, respectively. Of the 239 patients who achieved HBsAg <150 versus ≧150 IU/mL at end of treatment, the transition to inactive phase and HBsAg loss rates at year 5 after NA cessation were 57.2% versus 16.1% (p<0.001) and 25.4% versus 4.7%, respectively (p =0.001). The 10-year HBsAg loss rate after NA cessation for patients in Group I who remained in inactive phase, and Groups II+III and Group IV patients who transitioned to inactive phase were 57.7%, 45.4% and 55.1% (p=0.404), respectively.

Conclusions: Patients who remained or transitioned to the inactive phase had a high HBsAg loss rate without retreatment within 2 years after NA cessation.