Stopping Preemptive Antiviral Therapy for Hepatitis B Virus Can Be Considered for Patients with Favorable Predictors

Background: Preemptive antiviral therapy is recommended for chronic hepatitis B virus (HBV)-infected patients receiving cytotoxic chemotherapy. However, little data are available for the stopping therapy. Aims: We evaluated clinical outcome and predictors of off-treatment virological response of patients who discontinued therapy. Methods: Ninety-five adult patients who discontinued therapy were enrolled. They were analyzed for sustained off-treatment virological response, defined as HBV DNA levels below 2000 IU/ml for at least 12 months after the end of therapy. Results: Sustained off-treatment virological response was seen in 52 patients (54.7 %). The baseline HBV DNA level was an independent factor associated with sustained off-treatment virological response, and the rate was 72.1 and 23.5 % for those with HBV DNA < 2000 IU/ml and ≥2000 IU/ml, respectively (P < 0.001). The duration of consolidation treatment showed marginal association with sustained off-treatment virological response [odd ratio (95 % confidence interval) 1.20 (0.98–1.47), P = 0.069] for those with baseline HBV DNA < 2000 IU/ml, but not for those with ≥2000 IU/ml. The sustained off-treatment virological response rate was 54.5, 71.4, 73.9, and 100 % for consolidation treatment duration of <3, 3–6, 6–12, and ≥12 months, respectively, among those with baseline HBV DNA < 2000 IU/ml. Conclusions: The baseline HBV DNA level was indicator for sustained off-treatment virological response after stopping preemptive antiviral therapy. Consolidation treatment duration showed association with sustained off-treatment virological response only for those with low baseline HBV DNA levels.