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Letter
Discontinuation of long-term NA therapy in HBeAg-negative chronic hepatitis B
  1. Stephanos Hadziyannis1,
  2. Yun-Fan Liaw2
  1. 1 Liver Unit and its Molecular Biology Laboratory of the National and Kapodistrian University of Athens, Evgenidion Hospital, Athens, Greece
  2. 2 Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan
  1. Correspondence to Professor Stephanos Hadziyannis, Liver Unit and its Molecular Biology Laboratory of the National and Kapodistrian University of Athens, Evgenidion Hospital, Athens, Greece, 20 Papadiamantopoulou Str, Athens 11527, Greece; hadziyannis{at}ath.forthnet.gr

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We read the article of Seto et al 1 and we were really surprised by a very high rate of virological relapse (91%), much higher than 58% in a similar study by Jeng et al,2 and their conclusion that “the high rates of virologic relapse suggest that nucleos(t)ide analogue (NA) therapy should be continued indefinitely until the recognised treatment endpoint of HBsAg seroclearance”.

However, in hitherto conducted studies in Asian and Western patients with HBeAg-negative chronic hepatitis B, virological relapses alone defined as HBV DNA >2000 IU/mL with normal ALT levels, have first been monitored at frequent intervals while initiation of NA therapy again was considered only if ALT levels also increased >2× upper limit of …

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