BackgroundTreatment cessation in chronic HBV infection may be durable in certain patient subgroups before hepatitis B surface antigen (HBsAg) seroclearance. The role of serum HBV RNA in determining treatment cessation suitability has not been well-investigated.MethodsNucleos(t)ide analogue (NUC) treatment was discontinued in non-cirrhotic patients with chronic HBV with serum HBsAg <200 IU/mL and fulfilling internationally recommended criteria for treatment cessation. Patients were monitored till 48 weeks with baseline and serial measurements of serum HBsAg, HBV RNA and hepatitis B core-related antigen. NUCs were resumed when HBV DNA reaches >2000 IU/mL regardless of alanine aminotransferase (ALT) levels.Results114 entecavir-treated patients (median age 58.4 years, median serum HBsAg 54.4 IU/mL) with median treatment duration of 6.7 years were recruited. The 48-week cumulative rate of HBV DNA >2000 IU/mL was 58.1%. End-of-treatment serum HBV RNA and off-treatment serial HBV RNA were both independently associated with HBV DNA >2000 IU/mL (HR 2.959, 95% CI 1.776 to 4.926, p<0.001; HR 2.278, 95% CI 1.151 to 4.525, p=0.018, respectively). Patients with HBV RNA ≥44.6 U/mL had a cumulative 48-week rate of 93.2%, while combining HBV RNA undetectability and HBsAg <10 IU/mL had a cumulative 48-week rate of 9.1%. 24 patients (38.7%) developed off-treatment ALT elevation, highest peak ALT was 1515 U/L. 8 patients (median serum HBsAg 2.6 IU/mL) developed HBsAg seroclearance.ConclusionSerum HBV RNA measurement is essential for deciding on entecavir cessation in patients with chronic HBV, especially with low HBsAg levels. Patients can be stratified on their risk of off-treatment relapse based on both viral determinants.Trial registration numberNCT02738554

This article represents an attempt to look at the impact of modernization on how older people in China perceive their own image and status. Findings from a study conducted in Wuhan, China reveal that modernization has tarnished the image and lowered the status of older people, who still welcome their country's modernization as it has made marked improvements in their standard of living. Differences in reactions towards modernization are also found to exist between urban and rural older residents -an issue that the Chinese Government must redress to promote positive ageing.

Gerontologists have recognised the important influence of leisure activity on the mental and physical health of older adults. To date, however, there have been few studies of the patterns of participation in leisure activity among older adults in Hong Kong. This study examines a large representative sample of Hong Kong older adults and the associations between their socio-economic and health characteristics and their leisure activities. The data are from a cross-sectional survey of 2,180 respondents aged 60 or more years, conducted in 2000 by the Hong Kong Census and Statistics Department. There were full records for 2,144 respondents. Among the participation rates in the seven categories of leisure activities, watching television or listening to radio was the highest, while the lowest was for playing mahjong or cards. The characteristics that significantly correlated with the level of participation differed by the activity. Although no consistent pattern emerged, gender, education, employment status, receiving welfare benefits, self-rated health and functional impairment were the strongest correlates for most types of leisure activity. The paper is concluded by comparing the results with previous findings, and by discussing the service implications of the findings, the limitations of the study, and directions for future research.