Why not to stop antiviral treatment in patients with chronic hepatitis B


Treatment of chronic hepatitis B with entecavir or tenofovir leads to viral suppression in almost all patients. However, prolonged or lifelong treatment is necessary. At present, there is no consensus among the three major guidelines for the treatment of chronic hepatitis B on whether or not to stop antiviral treatment. One of the main reasons for this controversy is that virological relapse has been well documented in patients with chronic hepatitis B who stop treatment. Relapse rate is particularly high in patients who are HBeAg‐negative when treatment begins, with reported relapse rates of up to 70% 36 months after treatment discontinuation. Moreover, hepatic decompensation, jaundice and death have been described in patients with cirrhosis after treatment discontinuation. The main reason for stopping antiviral treatment is related to cost, however there is no robust evidence to support treatment discontinuation in most patients.


antivirals, chronic hepatitis B, discontinuation, flare, nucleos(t)ide analogues


About Speaker




City: Buenos Aires

Institution: Chief, Liver Unit. Hospital Italiano

Contact: adrian.gadano@hospitalitaliano.org.ar

Biography of Adrian GADANO

Dr. Adrian GADANO is an Associate Professor in Physiology, Gastro-Enterology and Hepatology at the University of Buenos Aires, Argentina and is in charge of the Liver Unit and Medical Director of the Transplant Unit at the Italian Hospital in Buenos Aires. He has been working for over 25 years in the management of patients affected with hepato-biliary diseases and liver transplantation.

Dr Gadano is Chief of the Research Department at the Italian Hospital and he has conducted, coordinated and participated in several international clinical trials in the fields of viral hepatitis, complications of cirrhosis, hepatocellular carcinoma and liver transplantation.

He has been President of the Argentinian Association for the Study of Liver Diseases (AAEEH) and the Argentinian Society of Transplantation (SAT).

Dr Gadano is member of the Latin American Association of Liver Diseases (ALEH) and the European Association of the Study of Liver Disease. He is part of the Board of the International Club of Ascitis (ICA).

He has published over 150 original papers in official and peer-reviewed journals.

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