Managing Hepatitis B Treatment: Should I Stop My Medication?

What should I do?

Hello, I have been taking Tenofovir for over a year, and my HBeAg has turned negative.
I haven't checked my HBV DNA levels.
After taking Tenofovir for nearly another six months, should I stop the medication abruptly or taper it off, for example, taking one pill every two days? I recently immigrated abroad and cannot return to Taiwan for testing, and I cannot get tested here either.
I have one week of medication left, and it will be six months once I finish it.
Should I just stop taking it, or should I have someone send more from Taiwan? Thank you for your response.

Zhen, 20~29 year old female. Ask Date: 2006/09/23

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! After taking Entecavir, your e-antigen has successfully turned negative.
If you continue to use it for another six months and your liver function is currently normal, you can stop the medication immediately without the need for a gradual taper.
The decision to discontinue should be discussed with your physician, and any follow-up plans should also be discussed with your attending doctor.

Reply Date: 2006/09/23

More Info

Managing Hepatitis B treatment can be a complex decision, especially when considering whether to continue or stop medication like Entecavir (甘安能). Based on your situation, where you have been on Entecavir for over a year and have achieved e-antigen seroconversion (e抗原轉陰), it is essential to approach the decision with caution and a clear understanding of the implications.

Should You Stop Your Medication?
1. Consultation with a Healthcare Provider: Ideally, the decision to stop or continue medication should be made in consultation with a healthcare provider who understands your medical history and current health status. Since you mentioned that you are unable to return to Taiwan for follow-up checks, it may be beneficial to seek a local healthcare provider who specializes in liver diseases or infectious diseases. They can help you assess your current condition and provide guidance tailored to your situation.

2. Monitoring HBV DNA Levels: You noted that you have not checked your HBV DNA levels recently. This is crucial because the level of HBV DNA in your blood can indicate whether the virus is still active. If the HBV DNA is undetectable, it may be safer to consider stopping the medication. However, if there is still detectable virus, stopping medication could lead to a resurgence of the virus, which might increase the risk of liver damage or complications.

3. Gradual Reduction vs. Immediate Discontinuation: If you decide to stop the medication, the general recommendation is to taper off rather than stopping abruptly. This could mean reducing the dose gradually (for example, taking one pill every other day) rather than stopping completely. However, this should be done under medical supervision to ensure that it is safe and appropriate for your specific case.

4. Risks of Stopping Medication: Stopping antiviral medication can lead to a rebound in viral replication, especially if the virus is still present in your system. This rebound can result in elevated liver enzymes and potentially lead to liver damage. Therefore, it is crucial to weigh the risks and benefits carefully.

5. Long-term Management: Hepatitis B is a chronic condition that requires ongoing management. If you stop your medication, you should have a plan for regular monitoring of your liver function and HBV DNA levels. This is to ensure that if the virus becomes active again, you can resume treatment promptly.

Additional Considerations
- Lifestyle Modifications: Regardless of your medication status, maintaining a healthy lifestyle is vital. This includes a balanced diet, regular exercise, avoiding alcohol, and managing stress. These factors can significantly impact liver health.

- Vaccination and Prevention: If you are planning to stay in a new country, ensure that you are up to date on vaccinations, especially for hepatitis A and other preventable diseases. This is crucial for individuals with liver conditions.

- Support Systems: Consider connecting with local support groups or online communities for individuals with hepatitis B. They can provide valuable resources and support as you navigate your treatment options.

In conclusion, while it may be tempting to stop your medication after achieving e-antigen seroconversion, it is essential to approach this decision with caution and ideally under the guidance of a healthcare provider. Regular monitoring and a thoughtful approach to discontinuing medication can help manage your hepatitis B effectively and reduce the risk of complications.

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