Chronic hepatitis type B patients who got rid of hepatitis B virus surface antigen (HBsAg) through long-term medication can discontinue the antiviral treatment, local researchers said in a study.

Professor Lee Jeong-hoon at the Department of Internal Medicine and Liver Research Institute at Seoul National University College of Medicine and his research team released the study, jointly conducted by 16 university hospitals, on Friday.

Professor Lee Jeong-hoon of the Department of Internal Medicine and Liver Research Institute at Seoul National University College of Medicine

Chronic hepatitis B affects about 260 million people worldwide. The disease is particularly common in East Asia, including Korea.

In the past, physicians used antiviral treatments to treat chronic hepatitis B. If the viral suppression by antiviral drugs goes successful and the patient tests negative for HBsAg, the patient is considered to have achieved “a functional cure.”

However, hepatitis B patients could not discontinue the antiviral treatment even after a functional cure because discontinuation of the antiviral drug could reactivate the virus and worsen liver functions. Such a case may lead to liver failure or even death.

Thus, patients with hepatitis B had no choice but to take the medication for the long term and come to terms with the risk of drug resistance, side effects, and financial burden.

The research team analyzed 276 patients from 16 hospitals whose long-term antiviral medications removed HBsAg. Then, the team compared the results of 131 who discontinued antiviral drug within six months after HBsAg cleared with those of 145 who continued the drug.

The researchers found that there was no difference between the two groups in terms of HBsAg reversion, serum hepatitis B virus DNA re-detection, or hepatocellular carcinoma risk.

The latest study was expected to be used as a basis for determining when to end chronic hepatitis B patient’s antiviral treatment, the researchers said.

It was the largest real-world, multicenter cohort study that directly compared the discontinuation with the continuation of the antiviral drug for the first time, they added.

“Since cirrhosis and previous history of antiviral resistance might be associated with a higher risk for HBsAg reversion and hepatitis B virus DNA re-detection, respectively, those patients require more attention and further prospective studies with larger sample size are warranted,” the research team noted.

The study was published in the online version of Gut, a medical journal by the British Society of Gastroenterology, on March 25.

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