The likelihood of HBsAg loss after discontinuation of nucleotide analogue therapy varies with patient ethnicity, HBV genotype, and viral antigen levels at the end of treatment. Patients with low HBsAg levels (<100 IU / mL) and / or undetectable HBcrAg levels, particularly those non-Asian or infected with HBV genotype C, appear to be the best candidates for treatment discontinuation.
It is unclear in which patients the loss of HBsAg occurs after discontinuation of nucleotide analogs. Therefore, this study investigated predictive factors in a cohort of HBeAg-negative patients with undetectable HBV DNA who discontinued long-term treatment with nucleotide analogues.
1,216 patients were included (991 with HBV genotype data). Of these, 98 (8.1%) achieved HBsAg loss. This was more likely in non-Asian patients (aHR 8.26; p <0.001) and in patients with lower HBsAg levels (aHR 0.243; p <0.001) and HBcrAg (aHR 0.718; p = 0.001). The combination of HBsAg ( 100 IE / ml) and HBcrAg ( 100 IU / ml and detectable HBcrAg. The percentages of patients with HBsAg loss also varied by HBV genotype. Furthermore, the highest percentages were observed for genotypes A and D; none of the patients with genotype E had HBsAg loss (p <0.001 for overall comparison between genotypes; p <0.001 for A / D versus B / C). HBV genotype C was independently associated with a higher probability of HBsAg loss than genotype B in Asian patients (aHR 2.494; 95% CI 1.490-4.174, p = 0.001).
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