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
- 주제(기타) Gastroenterology & Hepatology
- 설명문(일반) [Kim, Minseok Albert; Kim, Yoon Jun; Yoon, Jung-Hwan; Lee, Jeong-Hoon] Seoul Natl Univ, Seoul Natl Univ Hosp, Dept Internal Med, Coll Med, Seoul 03080, South Korea; [Kim, Minseok Albert; Kim, Yoon Jun; Yoon, Jung-Hwan; Lee, Jeong-Hoon] Seoul Natl Univ, Seoul Natl Univ Hosp, Liver Res Inst, Coll Med, Seoul 03080, South Korea; [Kim, Seung Up; Ahn, Sang Hoon] Yonsei Univ, Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Seung Up; Ahn, Sang Hoon] Yonsei Univ, Severance Hosp, Yonsei Liver Ctr, Coll Med, Seoul, South Korea; [Sinn, Dong Hyun; Park, Yewan] Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Sch Med, Seoul, South Korea; [Jang, Jeong Won; Yang, Hyun] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul St Marys Hosp, Seoul, South Korea; [Lim, Young-Suk] Univ Ulsan, Liver Ctr, Asan Med Ctr, Dept Gastroenterol,Coll Med, Seoul, South Korea; [Shim, Jae-Jun; Kim, Gi-Ae] Kyung Hee Univ, Dept Internal Med, Sch Med, Seoul, South Korea; [Seo, Yeon Seok; Lee, Han Ah] Korea Univ, Anam Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Baek, Yang Hyun; Koh, Myeongseok] Dong A Univ, Dept Internal Med, Coll Med, Busan, South Korea; [Kim, Sang Gyune; Kim, Young Seok] Soonchunhyang Univ, Bucheon Soonchunhyang Univ Hosp, Dept Internal Med, Coll Med, Bucheon, South Korea; [Kim, Ji Hoon; Lee, Young-Sun] Korea Univ, Coll Med, Dept Internal Med, Guro Hosp, Seoul, South Korea; [Choe, Won Hyeok] Konkuk Univ, Konkuk Univ Hosp, Dept Internal Med, Sch Med, Seoul, South Korea; [Yim, Hyung Joon; Kim, Minkoo] Korea Univ, Coll Med, Dept Internal Med, Ansan Hosp, Ansan, South Korea; [Lee, Hyun Woong] Yonsei Univ, Gangnam Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Lee, Hyun Woong] Yonsei Univ, Gangnam Severance Hosp, Yonsei Liver Ctr, Coll Med, Seoul, South Korea; [Kwon, Jung Hyun] Catholic Univ Korea, Coll Med, Dept Internal Med, Incheon St Marys Hosp, Incheon, South Korea; [Lee, Sung Won] Catholic Univ Korea, Coll Med, Dept Internal Med, Bucheon St Marys Hosp, Bucheon, South Korea; [Jang, Jae Young; Chang, Young] Soonchunhyang Univ, Seoul Soonchunhyang Univ Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Hwi Young] Ewha Womans Univ, Dept Inernal Med, Coll Med, Seoul, South Korea; [Zoulim, Fabien] Lyon Univ, Hosp Civils Lyon, Canc Res Ctr Lyon, INSERM,U1052, Lyon, France
- 등재 SCIE, SCOPUS
- 발행기관 BMJ PUBLISHING GROUP
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000175090
- 본문언어 영어
- Published As http://dx.doi.org/10.1136/gutjnl-2019-320015
- PubMed https://pubmed.ncbi.nlm.nih.gov/32209606
초록/요약
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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