Abstract
Chronic hepatitis B infection confers a major risk of cirrhosis and hepatocellular carcinoma worldwide. The ultimate long-term goal of chronic hepatitis B therapy is to reduce morbidity and mortality related to liver disease progression. The ideal treatment endpoint is HBsAg seroconversion. As HBsAg clearance is rarely achieved, the short-term goal of therapy is maintained suppression of hepatitis B replication. For HBeAg-positive patients, durable HBeAg seroconversion with undetectable HBVDNA is a satisfactory intermediate end-point. For HBeAg-negative patients, the treatment endpoint remains unclear, hence, sustained suppression of HBV DNA level to low or undetectable levels is the optimal treatment response. Several studies in HBeAg-negative population have proposed that discontinuation of antiviral treatment can be considered if undetectable serum HBV DNA is demonstrated on three separate occasions at least 6 months apart. Preliminary data suggests that on-treatment HBsAg quantification may play a role as a predictor of sustained response off-therapy.
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