Chronic Hepatitis b Clinical Trial
Official title:
Comparison and Prediction of Off-therapy Response in Patients of Chronic Hepatitis B Treated With Entecavir or Tenofovir and Achieved Criteria of Stopping Therapy by APASL Guideline
Pegylated-interferon (Peg-IFN) α-2a, entecavir (ETV) and tenofovir disoproxil fumarate (TDF)
are current recommended first-line antiviral therapies for chronic hepatitis B (CHB).
Compared with Peg-IFN therapy, nucleot(s)ide analogue (NUC) therapy has the advantages of
having a potent antiviral effect, and good tolerance without side effect. The long-term
safety and efficacy of ETV and TDF therapy had also been identified. However, poor
durability of the effectiveness after stopping NUC therapy are encountered in the majority
of patients. Previous study identified a high HBV relapse rate of over 50% in HBeAg-
positive CHB patients treated with lamivudine. A recent study investigating the
post-treatment durability of ETV showed that higher to 45.3% of the HBeAg-negative CHB
patients happened a clinical relapse within 1-year after stopping ETV therapy. TDF is
another recommended first line NUC with high potency and high genetic barrier. Although the
efficacy of long-term TDF therapy had been identified, there is lack of data regarding the
off-therapy response in CHB patients with TDF therapy currently. Only a small scale of
patients treated with TDF were included in a recent study investigating off-therapy relapse
in non-cirrhotic HBeAg-negative CHB patients after greater than 4 years of NUC therapy. In
addition, the factors associated with off-therapy response are also still uncertain.
The investigators plan to enrolled 400 CHB patients who had received oral antiviral therapy
ETV or TDF and achieved the Asia Pacific association of the study of liver (APASL) criteria
of stopping NUC therapy. The aims of the study are to investigate the rate of HBV relapse
including virological and clinical relapse in all and between patients with ETV and TDF
therapy, and to identify the predictive factors of relapse.
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