Published online Jul 28, 2015. doi: 10.3748/wjg.v21.i28.8653
Peer-review started: January 30, 2015
First decision: March 10, 2015
Revised: March 26, 2015
Accepted: May 2, 2015
Article in press: May 4, 2015
Published online: July 28, 2015
Processing time: 181 Days and 13.4 Hours
AIM: To investigate the virological relapse rate in hepatitis B e antigen (HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.
METHODS: Among patients diagnosed with chronic hepatitis B infection between May 2005 and July 2010, 204 were eligible for analysis. The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups. The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.
RESULTS: The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41% (162/204) and 43.82% (71/162), respectively. Multivariate analysis revealed that only post treatment hepatitis B surface antigen (HBsAg) level was associated with virological relapse (P = 0.011). The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥ 1500 IU/L than in those with HBsAg levels < 1500 IU/L (P = 0.0013). The area under the curve was 0.603 (P = 0.033). The cutoff HBsAg value for predicting virological relapse was 1443 IU/L.
CONCLUSION: We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.
Core tip: To study the rate of virological relapse in hepatitis B e antigen (HBeAg)-negative patients after stopping antiviral therapy. Two hundred and four patients were eligible for this analysis. The cumulative probability of virological relapse after stopping antiviral therapy was 79.41% (162/204) in 2 years and 43.82% (71/162) in 1 year. Cumulative probability of virological relapse in levels of the hepatitis B surface antigen (HBsAg) ≥ 1500IU/L group was higher than that of levels of the HBsAg < 1500 IU/L group. The cutoff value for predicting virological relapse was 1443 IU/L. We found that the virological relapse rate maintained a high level after stopping NUCs in HBeAg-negative patients and HBsAg levels of cessation of nucleos(t)ide analogs predicted virological relapse.