Patterns of Hepatitis B Virus Viremia Change and Hepatitis B Surface Antigen Loss Rate in Patients Without Retreatment Within 2 Years After Entecavir or Tenofovir Cessation.

[INTRODUCTION] This study investigated the patterns of hepatitis B virus (HBV) viremia change and hepatitis B surface antigen (HBsAg) loss rate without retreatment within 2 years after nucleos(t)ide analog (NA) cessation.

[METHODS] We enrolled 481 patients who did not receive retreatment in the first 2 years after entecavir or tenofovir disoproxil fumarate cessation.

[RESULTS] Group I was defined as persistent HBV DNA <2,000 IU/mL and normal alanine transaminase < 40 U/mL (inactive phase); Group II and Group III, as HBV DNA >2,000 IU/mL and ALT <40 U/L (Group II) or alanine transaminase 40-80 IU/mL (Group III); and Group IV, as HBV DNA >2,000 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 vs ≧150 IU/mL at the end of treatment, the transition to inactive phase and HBsAg loss rates at year 5 after NA cessation were 57.2% vs 16.1% ( P < 0.001) and 25.4% vs 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.

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