When Can I Stop Taking Gan An Neng for Hepatitis B Treatment?

Q: When Can I Stop Taking Gan An Neng for Hepatitis B Treatment?

Hello Tony： According to the 2005 Asia-Pacific consensus on hepatitis B, the optimal treatment regimen for e-negative hepatitis B is still unclear and should be individualized. <br>It is recommended to treat for at least one year, as the risk of drug resistance is related to the

When can "Gan An Neng" be discontinued?

Hello:
1.
I am a hepatitis B patient, HBsAg positive, with e-negative mutant type.
I undergo ultrasound examinations and liver function tests every three months, and my liver enzymes have been elevated.

2.
As of the end of February this year, my GOT was 169, GPT was 306, and the qualitative test for hepatitis B virus at Cheng Kung University was positive, with a quantitative result of 3,657,000 copies/ml.
Based on my doctor's recommendation, I started taking Tenofovir in mid-March.
After one month, my GOT was 50 and GPT was 812.
After two months, GOT was 48 and GPT was 423.
After three months, GOT was 36 and GPT was 454.
After four months, GOT was 32 and GPT was 445.
After five months, GOT was 30 and GPT was 36, which have been normal for six months.
After another test at Cheng Kung University, both qualitative and quantitative results for hepatitis B were negative.
After seven months, GOT was 23 and GPT was 258.
After eight months, GOT was 27 and GPT was 259.
After nine months, GOT was 26 and GPT was 254.
Currently, I am nearing the end of my tenth month of Tenofovir, and my liver enzymes are normal, with no abnormalities noted in the ultrasound examinations every three months.

3.
When can I stop taking Tenofovir? The clinic doctor initially said to take it for one year, but now says to take it for a year and a half.
Is this necessary? Will there be a risk of developing drug resistance?
4.
Please respond, thank you.

Tony, 60~69 year old female. Ask Date: 2005/12/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Tony: According to the 2005 Asia-Pacific consensus on hepatitis B, the optimal treatment regimen for e-negative hepatitis B is still unclear and should be individualized.
It is recommended to treat for at least one year, as the risk of drug resistance is related to the duration of use, but the success rate must also be considered.
Therefore, it can only be determined based on individual circumstances.
Wishing you a speedy recovery, Chen Shidian.

Reply Date: 2005/12/14

More Info

When considering stopping Gan An Neng (Entecavir) for the treatment of Hepatitis B, there are several important factors to take into account. Based on your situation, it appears that you have made significant progress in your treatment, with your liver function tests (GOT and GPT) returning to normal levels and your HBV DNA becoming undetectable. However, the decision to stop treatment should not be taken lightly and should ideally involve a thorough discussion with your healthcare provider.

1. Duration of Treatment: The general recommendation for patients with chronic Hepatitis B who have achieved viral suppression is to continue antiviral therapy for at least 12 months after achieving a sustained response. In your case, since you have been on Gan An Neng for about 10 months and have shown consistent improvement, your doctor may suggest continuing treatment for a total of 12 to 18 months. This extended duration helps to ensure that the virus is fully suppressed and reduces the risk of relapse.

2. Risk of Relapse: Studies indicate that stopping antiviral therapy can lead to a significant risk of relapse, especially in patients with HBsAg positive status. The relapse rate can be as high as 30% or more within the first year after stopping treatment. Therefore, it is crucial to weigh the benefits of continuing treatment against the potential risks of stopping too early.

3. Monitoring: If you decide to stop treatment, regular monitoring is essential. This includes liver function tests and HBV DNA testing to ensure that the virus remains suppressed. Your healthcare provider may recommend follow-up appointments every three months for the first year after stopping treatment.

4. Antiviral Resistance: Concerns about developing antiviral resistance are valid, particularly if treatment is stopped prematurely. However, Entecavir is known for its low resistance profile compared to other antiviral medications. If you have been compliant with your treatment regimen, the likelihood of developing resistance is significantly reduced.

5. Consultation with a Specialist: Given the complexity of Hepatitis B management, it is advisable to consult with a hepatologist or an infectious disease specialist who can provide personalized recommendations based on your specific medical history and current health status. They can help determine the optimal time to stop treatment and the necessary follow-up care.

6. Lifestyle Considerations: While undergoing treatment, maintaining a healthy lifestyle is crucial. This includes avoiding alcohol, eating a balanced diet, and managing any co-existing health conditions. These factors can significantly impact your liver health and overall well-being.

In summary, while you have made excellent progress in your treatment for Hepatitis B, the decision to stop Gan An Neng should be made in consultation with your healthcare provider. They will consider your current health status, the duration of treatment, and the potential risks of relapse before making a recommendation. Regular monitoring after stopping treatment is essential to ensure that your liver remains healthy and that the virus does not reactivate.

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