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Results of Nucleos(t)ide Analog Treatment Discontinuation in Hepatitis B e-Antigen-Negative Chronic Hepatitis B: NUCSTOP Study

Volume 35 · Issue 1 · January 2024 Publish Date: January 2, 2024
Sercan Kiremitçi 1 ORCID Koray Koçhan 2 ORCID Gülseren Seven 3 ORCID Elmas Biberci Keskin 4 ORCID Gülay Okay 5 ORCID Yasemin Akkoyunlu 6 ORCID Meliha Meriç Koç 7 ORCID Bilge Sümbül 8 ORCID Hakan Şentürk 9 ORCID
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Turkish Journal of Gastroenterology

Volume 35 · Issue 1 · January 2024

Pages: 17-26

History

Published Online: January 2, 2024

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2024 Sercan Kiremitçi, Koray Koçhan, Gülseren Seven, Elmas Biberci Keskin, Gülay Okay, Yasemin Akkoyunlu, Meliha Meriç Koç, Bilge Sümbül, Hakan Şentürk

Sercan Kiremitçi ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Koray Koçhan ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Gülseren Seven ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Elmas Biberci Keskin ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Gülay Okay ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
Yasemin Akkoyunlu ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
Meliha Meriç Koç ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
Bilge Sümbül ORCID
Department of Medical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
Hakan Şentürk ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Kiremitçi, S., Koçhan, K., Seven, G., Biberci Keskin, E., Okay, G., Akkoyunlu, Y., … Şentürk, H. (2024). Results of Nucleos(t)ide Analog Treatment Discontinuation in Hepatitis B e-Antigen-Negative Chronic Hepatitis B: NUCSTOP Study. Turkish Journal of Gastroenterology, 35(1), 17–26. https://doi.org/10.5152/tjg.2024.23463
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Abstract

Background/Aims: This study aims to investigate the effects of nucleos(t)ide analogs (NAs) discontinuation in eligible patients in accor dance with the Asian Pacific Association for the Study of the Liver hepatitis B guideline and the factors affecting clinical and virological relapses.

Materials and Methods: In this prospectively designed study, hepatitis B e antigen (HBeAg)-negative chronic hepatitis B patients who were followed up between 2012 and 2019 were evaluated and 57 patients were included. All participants enrolled the study were HBeAg negative status at NA initiation.

Results: The median age of the patients was 49 (29-72) years and 24 (42%) were females. The median treatment duration was 96 (36 276) months and patients were followed for a median duration of 27 months. Sixteen patients had a previous history of NA switch, and thirteen of these patients had a history of lamivudine resistance. Thirty-eight of 57 patients (66%) developed an elevated hepatitis B virus deoxyribonucleic acid level of >2000 IU/mL at least once, defined as virological relapse and 23 (60%) of them, experienced clinical relapse. Thirty-one of 57 patients were re-treated during the follow-up, and hepatitis B surface antigen (HBsAg) loss occurred among 4 (7%) patients. All patients who experienced HBsAg loss had a history of lamivudine resistance (P = .002).

Conclusion: Despite receiving NAs suppression therapy for a long time, HBsAg loss occurs rarely. Although it was not life-threatening, most patients experienced relapses and treatment should be restarted. In our study, whether it is a coincidence that all patients with HBsAg loss are patients in whom NAs are used sequentially due to lamivudine resistance is an issue that needs to be further investigated.

 

Cite this article as: Kiremitçi S, Koçhan K, Seven G, et al. Results of nucleos(t)ide analog treatment discontinuation in hepatitis B e-antigen-negative chronic hepatitis B: NUCSTOP study. Turk J Gastroenterol. 2024;35(1):17-26.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 35 · Issue 1 · January 2024
Pages 17-26
DOI 10.5152/tjg.2024.23463
History
Published Online January 2, 2024
License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright
Copyright (c) 2024 Sercan Kiremitçi, Koray Koçhan, Gülseren Seven, Elmas Biberci Keskin, Gülay Okay, Yasemin Akkoyunlu, Meliha Meriç Koç, Bilge Sümbül, Hakan Şentürk
Affiliations
1
Sercan Kiremitçi ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
2
Koray Koçhan ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
3
Gülseren Seven ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
4
Elmas Biberci Keskin ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
5
Gülay Okay ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
6
Yasemin Akkoyunlu ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
7
Meliha Meriç Koç ORCID
Department of Infectious Diseases and Clinical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
8
Bilge Sümbül ORCID
Department of Medical Microbiology, Bezmialem University School of Medicine, İstanbul, Turkey
9
Hakan Şentürk ORCID
Department of Gastroenterology, Bezmialem University School of Medicine, İstanbul, Turkey
Cite this Article
Kiremitçi, S., Koçhan, K., Seven, G., Biberci Keskin, E., Okay, G., Akkoyunlu, Y., … Şentürk, H. (2024). Results of Nucleos(t)ide Analog Treatment Discontinuation in Hepatitis B e-Antigen-Negative Chronic Hepatitis B: NUCSTOP Study. Turkish Journal of Gastroenterology, 35(1), 17–26. https://doi.org/10.5152/tjg.2024.23463
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