According to the WHO recommendations, which patients may be considered for discontinuation of nucleos(t)ide analogs (NAs) for the treatment of hepatitis B (HBV) (Hep B)?

Updated: Aug 01, 2018
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Individuals without clinical evidence of cirrhosis (or based on APRI score ≤2 in adults) who have all of the following features may be considered exceptionally for discontinuation of NAs:

  • Can be closely monitored for reactivation over the long term
  • Have evidence of HBeAg loss and seroconversion to anti-HBe (in those who were initially HBeAg positive), as well as after completion of at least one additional year of treatment
  • Have persistently normal ALT levels and persistently undetectable HBV DNA levels (where HBV DNA testing is available). (If HBV DNA testing is not available, consider discontinuation of NA therapy in those with evidence of persistent hepatitis B surface antigen [HBsAg] loss and after completion of at least one additional year of treatment, regardless of their previous HBeAg status).

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