Deliberations more than a cut‐off HBsAg value for Nuc cessation

Abstract

We agree with the conclusion of the systemic review by Liu J et al.(1) that end of treatment (EOT) quantitative HBsAg (qHBsAg) < 100 IU/ml could be a level for stopping nucleos(t)ide analuges therapy.

However, we were surprised that: (A), several important off‐therapy studies meeting authors' selection criteria were neglected (Chen CH CGH 2015; Hsu YC CGH 2016; Wang CC AJG 2016; online by 2017/12: Tseng CH J Formos Med Assoc 2018). Further, 95 patients in the 2013 study(2) were counted twice as they were included in 691 patients of the 2018 study(3); (B), HBV DNA low detection limit in the included studies varied from 12~1000IU/ml. Relapse rate very likely will be higher in patients with EOT HBV DNA up to 1000IU/ml, hence should not be lumped together.

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