Dear @La.sciamachie ,
Thank you for these comments. They are appreciated.
It would be impossible to address how patient’s levels of integration decline over time after NAP therapy for the following reasons:
-
It would require serial liver biopsies (which does not make ethical sense in patients with functional cure).
-
Even if these liver biopsies were possible, they do not constitute a good sampling of what is going on in the liver because HBV infection is heterogenous.
What other groups have shown is that integration levels are reduced in patients who achieve functional cure and this is almost certainly the case with NAPs.
More importantly, as the follow-up time after NAPs has progressed we see the liver is healing because liver stiffness measurements become normal. This is an indication of reversal of fibrosis.