核苷（酸）类似物治疗可以停止

Nucleos(t)ide analogs can be stopped
Jidong Jia
Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
On the second day of APASL, Professor Jidong Jia made a report titled as “Nucleos(t)ide analogs can be stopped”. One argument against the use of nucleos(t)ide analogs in HBV infection is that long-term therapy, even life-long therapy is needed. In the speaker’s opinion, this is not true in the following situations:
1. Chronic hepatitis B is an infectious disease, not a genetic disease.

2. Clinical reports show that short duration of NAs is effective for those with refractory course or severe clinical manifestations.
3. Even for chronic hepatitis B, clinical evidence shows that once the HBV DNA is suppressed for an extended period of time and HBeAg seroconversion has been achieved, NAs can be stopped after an 6 months of consolidation.

He said “HBeAg seroconversion rate and their durability are determined by host factors and virological profiles. Therefore, clinicians should clearly understand all these baseline factors and carefully weigh these variables in deciding whether to treat a patient, what to use and for how long to treat.”

在APASL会议第二天，贾继东教授就抗HBV核苷（酸）类似物治疗是否需长期甚至终身治疗发表了自己的观点。他认为NAs治疗可以停止，因为：慢性乙型肝炎非遗传性疾病；有报道显示短期Nas治疗对于难治或临床表现严重患者有效；即使为慢性乙型肝炎，达到病毒抑制、HBeAg血清学转换巩固治疗半年后亦可停药。故疗程的选择应综合分析患者因素及病毒因素。