Guidelines for avoiding risks resulting from discontinuation of nucleoside/nucleotide analogs in patients with chronic hepatitis B

EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection

“…228,[230][231][232] Some studies suggest that this biomarker can be also used to monitor NA or PegIFNa based treatments and predicting therapeutic efficacy including the risk of relapse after stopping NAs. [233][234][235] Most of these studies were performed in Japan, and large correlation studies derived from Caucasian patients are lacking. Therefore, further studies are awaited providing clear evidence for a superiority of this marker for clinical decision making over established HBV biomarkers like HBsAg and HBV DNA quantification.…”

Hepatitis B core‐related antigen kinetics in chronic hepatitis B virus genotype D‐infected patients treated with nucleos(t)ide analogues or pegylated‐interferon‐α

“…Based on HBcrAg and HBsAg values at therapy month 36, patients treated with NA were further classified according to the relapse risk score following NA therapy cessation proposed by the Japan Society of Hepatology (JSH) guidelines . All rapid decliner patients were classified into the moderate risk group (total score 1 [ n = 6] or 2 [ n = 6]); patients in the HBcrAg‐positive group at month 36 were classified into the high risk of relapse group (total score 1 [ n = 1], 3 [ n = 2], or 4 [ n = 5]) ( P = 0.0005).…”

Telbivudine therapy for chronic hepatitis B: A journey to identify super‐responders and to optimize treatment using the roadmap model

“…The main goals of NAs are to suppress viral replication and reduce the risk of disease progression to cirrhosis or HCC . NAs lead to a rapid reduction in HBV DNA and normalization of serum ALT levels . However, most patients require prolonged or even lifelong therapy for sustained viral suppression .…”