When to stop treatment for hepatitis B

In the past, patients with hepatitis B virus (also known as HBV) were often recommended to take continuous, lifelong medication, with adherence to a regular schedule of follow-up visits. The goals of these specific drugs are to reduce the risk of severe disease progression and to help prevent the virus transmission to others. 

Recently, HBcrAg has been introduced and utilized in clinical practice and become a decisive factor to tell when it is appropriate to stop treatment. This is a good sign for patients having HBV and using medications in a long time. 

Hepatitis B Virus – a silient killer

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). The virus is most commonly transmitted through contact with blood, during sex and from mother to child during birth and delivery. HBV attacks directly to liver cells, leading to acute and chronic infection. The long-term injury of liver could result in cirrhosis, liver cancer and other severe or life-threatening liver diseases. 

HBV’s transmission routes are similar to HIV, but the infection probability of HBV is 100 times higher than HIV’s. In normal conditions, HBV can survive in 1 month, wheareas HIV does not live long and is unable to transmitted outside the body.

Picture: the infection probability of HBV is 100 times higher than HIV’s

HBV is a common cause of acute and chronic liver disease, leading to liver cirrhosis and cancer. These diseases are leading causes of death in Vietnam and the world. “The world is not fully aware of how dangerous hepatitis is. The time has come to mobilize a global effort to tackle this disease on a scale similar to the fight against other infectious diseases like HIV/AIDS and tuberculosis.” – according to the world’s leading experts. 

For a world without hepatitis B virus patients

Together with the world, Vietnam actively participates in activities to celebrate the "World Hepatitis Prevention Day" on July 28, 20 with the aim of "by 2030, the world will have no more hepatitis virus patients. No hepatitis patient is left behind.”

If hepatitis B is detected early and treated properly, it can be completely controlled. Therefore, prevention and early detection of hepatitis B are very important.

Currently, there are many tests that support the diagnosis and treatment of hepatitis B effectively, such as testing for HbsAg, HBeAg, Anti Hbe, HBV-DNA…The most recently introduced testing is HbcrAg (core antigen of hepatitis B virus) is believed to be a new advancement, pave the way for positive treatment directions and giving hope to people with hepatitis B.

HBcrAg – a new index in diagnosis and treatment of hepatitis B

When following up treatment hepatitis B, doctors always concern to cccDNA concentration in liver cells (cccDNA of HBV plays an important role on duplication and long existence of HBV). New studies have reported that the presence of HBcrAg in serum correlated with the cccDNA concentration. 

This new test, after being licensed by the Ministry of Health under Decision No. 3310/QD-BYT, quickly received positive feedback from clinicians as well as brought good news to patients who had to undergo treatment of chronic hepatitis B.

Picture: Hoang Long Clinic is one of the few medical centers to include HBcrAg testing in the management of hepatitis B

Dao Viet Hang, MD, PhD – The Institute of Gastroenterology and Hepatology shared “HBcrAg brings many positive results, is one of the indicators to help doctors monitor and evaluate the effectiveness of the current treatment of hepatitis B. With HBcrAg, we are also more confident in deciding whether to stop or continue using the antiviral drugs.”

HbcrAG – decisive factor to help doctors indicate patients to stop treatment for hepatitis B

In the past, people with hepatitis B virus (also known as HBV) were often recommended to take continuous, lifelong medication, with adherence to a regular schedule of follow-up visits. When discontinuing antiviral therapy, it's important to perform multiple tests at the same time. This is not only challenging for doctors, but also put a higher level of financial burden on patients. 

After the HbcrAg test was officially implemented in the Institute of Gastroenterology and Hepatology and Hoang Long Clinic, based on the results of follow-up tests on hepatitis patients , when the HbcrAg test is NEGATIVE, the doctor can consider and decide for the patient to stop taking antiviral drugs for a certain period.

Picture: Dao Viet Hang, MD, PhD