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- Title
Clinical outcomes after interruption of entecavir therapy in HBeAg-negative chronic hepatitis B patients with compensated cirrhosis.
- Authors
Chen, Y. C.; Peng, C. Y.; Jeng, W. J.; Chien, R. N.; Liaw, Y. F.
- Abstract
Background Long-term nucleos(t)ide analogues therapy may reduce hepatocellular carcinoma ( HCC) in chronic hepatitis B patients with advanced fibrosis or cirrhosis. Aim To investigate in a retrospective-prospective study whether this beneficial effect would be reduced in cirrhotic patients who discontinued a successful course of entecavir ( ETV) therapy. Methods The study included 586 hepatitis B e antigen ( HBeAg)-negative patients with compensated cirrhosis, mean age of 53.8 ± 10 years and 81% males, treated with ETV for at least 12 months. After ETV therapy for 46.5 ± 22.9 months, 205 patients who achieved hepatitis B virus ( HBV) DNA suppression discontinued therapy. The clinical outcomes were assessed and HCC incidence was compared between propensity score ( PS)-matched patients who continued and patients who discontinued ETV therapy by Asian Pacific Association for the Study of Liver stopping rule. Results During a mean duration of 59.3 ± 19 months after start of ETV therapy, nine and six HCC developed in an estimated annual incidence of 2.3% and 1.6% in 154 PS-matched patients who continued and who discontinued ETV therapy, respectively ( P = 0.587). Multivariate Cox proportional hazards regression analyses showed that age ( HR 1.065, P < 0.001) and HBV DNA ( HR 1.216, P = 0.048) were the significant factors for HCC development. The rates of adverse clinical outcomes were comparable. Conclusions The clinical outcomes, including HCC, after cessation of a successful course of entecavir therapy in patients with compensated cirrhosis were comparable to those who continued therapy. The results suggest that this strategy of finite therapy is safe and a feasible alternative to indefinite therapy, especially in a low resources setting.
- Subjects
HEPATITIS associated antigen; CHRONIC hepatitis B; CIRRHOSIS of the liver; NUCLEOSIDES; HEPATITIS B virus; DNA; THERAPEUTICS
- Publication
Alimentary Pharmacology & Therapeutics, 2015, Vol 42, Issue 10, p1182
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.13409