Cho Hye Jeong, Shin Seung Kak, Kwon Oh Sang, Kim Ju Hyun, Kim Yun Soo
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Korean J Gastroenterol. 2020 Nov 25;76(5):256-260. doi: 10.4166/kjg.2020.111.
Although rare patients with chronic hepatitis B can achieve HBsAg loss on oral nucleos(t)ide analog (NA), the optimal timing of stopping oral NAs safely has been considered when HBsAg and HBV DNA are negative in the serum because HBsAg loss induced by nucleos(t)ide analogs (NAs) appears to be durable if immunosuppressive therapy or chemotherapy are not done. On the other hand, the author experienced a case of HBsAg seroreversion and acute decompensation after the discontinuation of NA in a patient with HBsAg loss. This rare case highlights the need for the close monitoring of patients who achieved HBsAg loss and stopped NA.
虽然少数慢性乙型肝炎患者口服核苷（酸）类似物（NA）后可实现HBsAg清除，但在血清中HBsAg和HBV DNA均为阴性时，才被认为是安全停用口服NA的最佳时机，因为如果不进行免疫抑制治疗或化疗，核苷（酸）类似物（NA）诱导的HBsAg清除似乎是持久的。另一方面，作者遇到1例HBsAg清除的患者在停用NA后出现HBsAg血清学逆转和急性失代偿的情况。这一罕见病例凸显了对实现HBsAg清除并停用NA的患者进行密切监测的必要性。
