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We read the article of Seto et al1 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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