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Int J Infect Dis. 2019 Sep;86:201-207. doi: 10.1016/j.ijid.2019.07.036. Epub 2019 Aug 5.

Predictors of relapse after cessation of nucleos(t)ide analog treatment in HBeAg-negative chronic hepatitis B patients: A meta-analysis.

Author information

1
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China; Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180# Fenglin Road, Shanghai, People's Republic of China.
2
Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai, People's Republic of China.
3
Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180# Fenglin Road, Shanghai, People's Republic of China.
4
Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180# Fenglin Road, Shanghai, People's Republic of China. Electronic address: jiang.wei@zs-hospital.sh.cn.
5
Department of Ophthalmology, Zhongshan Hospital, Fudan University, 180# Fenglin Road, Shanghai, People's Republic of China. Electronic address: wzafengyifan@163.com.

Abstract

OBJECTIVES:

The aim of this study was to identify the predictors of relapse after the withdrawal of nucleos(t)ide analog (NA) therapy in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB).

METHODS:

The PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched through January 2019. A random-effects model meta-analysis was performed, with hazard ratios (HR) and 95% confidence intervals (CI) used as summary statistics.

RESULTS:

Seventeen studies were included in the meta-analysis. Age (HR=1.022 per year), baseline hepatitis B surface antigen (HBsAg) (HR=1.509 per log IU/l), end of treatment (EOT) HBsAg level (HR=1.896 per log IU/l), EOT HBsAg level ≥1000 IU/ml (HR=1.749), and HBsAg decline from baseline to EOT (HR=0.748 per log IU/l) were associated with virological relapse. The predictors of clinical relapse were baseline HBsAg level (HR=1.312 per log IU/l), EOT HBsAg level (HR=1.458 per log IU/l), EOT HBsAg level ≥100IU/ml (HR=3.199) or ≥1000 IU/ml (HR=1.810), and duration of consolidation therapy (HR=0.991 per month).

CONCLUSIONS:

This meta-analysis indicates that age, the duration of consolidation therapy, and levels of baseline and EOT HBsAg were factors predictive of relapse in HBeAg-negative CHB patients who discontinued NA treatment.

KEYWORDS:

Chronic hepatitis B; HBeAg-negative; Nucleot(s)ide analogs; Stopping therapy

PMID:
31394205
DOI:
10.1016/j.ijid.2019.07.036
[Indexed for MEDLINE]
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