Current Hepatology Reports

, Volume 18, Issue 4, pp 512–521 | Cite as

Evidence-Based Approach to Stopping Oral Antiviral Therapy in Chronic HBV

  • Maximilian Wübbolding
  • Markus CornbergEmail author
  • Christoph Höner zu Siederdissen
Hepatitis B (J Lim, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hepatitis B


Purpose of Review

To review the evidence for stopping antiviral therapy with nucleos(t)ide analogues (NA) in patients with chronic hepatitis B.

Recent Findings

HBsAg loss is usually stable even without anti-HBs seroconversion after stopping NA therapy. About 50% of HBeAg-positive patients who have achieved anti-HBe seroconversion and have stopped NA therapy remain in virological remission. Consolidation therapy increases the response rate. In HBeAg-negative hepatitis, stable virological remission is documented in 30% after NA discontinuation. Interestingly, some studies document unexpectedly high long-term HBsAg loss rates after stopping therapy.


Evidence supports NA discontinuation, especially after HBsAg seroclearance. In HBeAg-positive patients, NA can be stopped 12 months after anti-HBe seroconversion but severe flares have to be considered. NA discontinuation is also possible in selected HBeAg-negative patients if close monitoring can be guaranteed. The high rate of HBsAg loss needs further evaluation.


Treatment discontinuation Nucleos(t)ide analogues HBeAg seroconversion HBeAg negative HBsAg loss 


Compliance with Ethical Standards

Conflict of Interest

Maximilian Wübbolding declares no potential conflicts of interest. Markus Cornberg reports personal fees for lectures and advisory boards from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag (Data Safety Board), Roche, Merck (MSD), Biogen, Falk Foundation, Boehringer Ingelheim, Siemens, and Spring Bank. Dr. Cornberg reports a grant from Roche. Christoph Höner zu Siederdissen reports travel grants from Gilead Sciences and Novartis.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maximilian Wübbolding
    • 1
  • Markus Cornberg
    • 1
    • 2
    • 3
    • 4
    • 5
    Email author
  • Christoph Höner zu Siederdissen
    • 1
  1. 1.Department of Gastroenterology, Hepatology and EndocrinologyHannover Medical SchoolHannoverGermany
  2. 2.German Center for Infection Research (DZIF), partner site Hannover-BraunschweigHannoverGermany
  3. 3.Centre for Individualised Infection Medicine (CIIM)HannoverGermany
  4. 4.Helmholtz Centre for Infection Research (HZI)BraunschweigGermany
  5. 5.Cluster of Excellence Resolving Infection Susceptibility (RESIST; EXC)Hannover Medical SchoolHannoverGermany

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