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. 2019 Oct 4;14(10):e0222221.
doi: 10.1371/journal.pone.0222221. eCollection 2019.

Incidence and predictors of retreatment in chronic hepatitis B patients after discontinuation of entecavir or tenofovir treatment

Te-Ling Ma  1 , Tsung-Hui Hu  1 , Chao-Hung Hung  1 , Jing-Houng Wang  1 , Sheng-Nan Lu  1 , Chien-Hung Chen  1
Affiliations

Incidence and predictors of retreatment in chronic hepatitis B patients after discontinuation of entecavir or tenofovir treatment

Te-Ling Ma et al. PLoS One. .

Abstract

Background: This study investigated the incidence and predictors of retreatment after discontinuation of either entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment in Taiwan.

Methods: A total of 535 non-cirrhotic chronic hepatitis B (CHB) patients undergoing either ETV (n = 358) or TDF (n = 177) treatment were enrolled. Patients were followed for at least 12 months after stopping ETV or TDF treatment. Most patients (86.3%) fulfilled the retreatment criteria of Taiwan's National Health Plan.

Results: The 5-year cumulative rates of clinical relapse and retreatment were 52.1% and 47%, respectively, in 160 hepatitis B e antigen (HBeAg)-positive patients, and were 62% and 54.8%, respectively, in 375 HBeAg-negative patients. The median duration from the end of treatment until clinical relapse and retreatment was 40 and 57 weeks, respectively, for all patients. Multivariate Cox regression analysis revealed that discontinuing TDF treatment, old age, male gender, and higher baseline HBsAg levels were independent factors of retreatment in HBeAg-positive patients; old age, HBV genotype B, and higher baseline and end-of-treatment HBsAg levels were independent factors in HBeAg-negative patients. A total of 18.8% of retreated patients satisfied the retreatment criteria of hepatic decompensation according to Taiwan's National Health Plan. Of the 64 patients who had clinical relapse without retreatment, 17 achieved sustained virological remission and 26 did not experience clinical relapse until their last visit after clinical relapse. Four patients developed HBsAg loss.

Conclusions: The 5-year retreatment rate was about 50% in HBeAg-positive and HBeAg-negative patients. Discontinuing TDF treatment was an independent factor of retreatment in HBeAg-positive patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of patients enrolled in this study.
Fig 2
Fig 2
Cumulative incidences of clinical relapse and retreatment in (A) HBeAg-positive and (B) HBeAg-negative patients.
Fig 3
Fig 3
Comparison of the incidences of retreatment between entecavir (ETV) and tenofovir disoproxil fumarate (TDF) in (A) HBeAg-positive and (B) HBeAg-negative patients.
Fig 4
Fig 4. Cumulative incidences of retreatment according to end-of treatment HBsAg levels in HBeAg-negative patients.
See this image and copyright information in PMC

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