Long-term outcomes after nucleos(t)ide analogue cessation in chronic hepatitis B – follow-up from the RETRACT-B cohort

作者：Edo J. Dongelmans, Grishma Hirode, Florian van Bӧmmel, Wen-Juei Jeng, Rong-Nan Chien, Chien-Hung Chen, Mai Kilany, Ta‐Chen Su, J. Tze-Wah Kao, Wai-Kay Seto, Lilian Yan Liang, Dag Henrik Reikvam, Marte Holmberg, Arno Furquim d'Almeida, Μargarita Papatheodoridi, Benjamin Maasoumy, Bettina Hansen, Richard Post, Anna Pocurull, Norah Terrault, Marc Ghany, Asgeir Johannessen, Anna Lok, Thomas Vanwolleghem, Sabela Lens, Markus Cornberg, Man-Fung Yuen, Grace Wong, Milan J. Sonneveld, George Papatheodoridis, T. Berg, Yao‐Chun Hsu, Jordan Feld, Harry Janssen · 发表于：Journal of Hepatology · 年份：2026 · DOI：10.1016/j.jhep.2026.03.030 · 被引用次数：3 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Liver Diseases and Immunity

BACKGROUND & AIMS: Stopping nucleos(t)ide analogues (NAs) in patients with chronic hepatitis B can increase hepatitis B surface antigen (HBsAg) loss rates. However, long-term follow-up (FU) data after NA cessation in a multiethnic population are lacking. This study aimed to assess long-term outcomes after NA cessation in a large global cohort. METHODS: Extended FU data were collected from patients enrolled in the RETRACT-B cohort. New patients were added if they met the inclusion criteria (virally suppressed, HBeAg negative, and HBsAg positive at end of therapy [EOT]). The primary outcome was the 10-year off-treatment HBsAg loss rate. Secondary outcomes were retreatment and adverse events. RESULTS: IU/ml (<100/100-1,000/≥1,000 IU/ml: 16/46/38%). Median FU was 65 [range 35-99] months. The 10-year off-treatment HBsAg loss rate was 17% (<100/100-1,000/≥1,000: 52/13/6%, p <0.001) and 59% were retreated (<100/100-1,000/≥1,000: 28/62/71%). HBsAg seroreversion was observed in 9 out of 171 (5.3%) patients, of whom 6 re-lost HBsAg. The 10-year risks of flares, hepatocellular carcinoma and decompensation were 30%, 3.9%, and 3.3%, respectively. A history of cirrhosis was associated with a higher risk of decompensation (10-year: 5.7% vs. 3.0%) and hepatocellular carcinoma (10-year: 12% vs. 2.4%), both p <0.001. CONCLUSION: At 10 years, 17% of patients achieved off-treatment HBsAg loss, whereas more than half were retreated. Patients with HBsAg levels <100 IU/ml benefit the most from NA c...