John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


When should treatment be stopped ? Volume 16, special issue 2, septembre 2009


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Service d’hépatologie, Inserm U773 CRB3, université Paris-VII, hôpital Beaujon, 92110 Clichy, France

These last 5 years, important progress has been made in the treatment of chronic hepatitis B (CHB), and seven drugs are currently licensed for the treatment of CHB: interferon alfa, pegylated interferon alfa-2a, lamivudine, adefovir, entecavir, telbivudine, and tenofovir. HBs seroconversion is the ideal goal of treatment since it is associated with long-term remission. In HBe positive CHB patients, HBV DNA suppression to undetectable levels in real-time PCR and subsequent HBe seroconversion are associated with biochemical and histological responses. Treatment can be stopped 6 to 12 months after HBe seroconversion, however, these patients require long-term follow-up because of the possibility of HBe seroreversion or HBeAg-negative CHB. Treatment should not be stopped in patients with cirrhosis. In HBe negative CHB patients, treatment should be administrated indefinitely.