My doctor had me monitor every two weeks at first, for 2 months then every month, then every 3 and after the first year I was back to the standard 6 month intervals. From the results of the StopNuc study my sister was enrolled in, they really didn’t see the dangerously high viral rebound. I’m not saying it can’t happen but I think the concern about this has been overstated and has led to many people being afraid to get off treatment, and staying on antivirals much longer than necessary. For many it‘s possible to be off meds for periods of 2- 5 years and beyond without viral rebound, and usually if it starts multiplying again it’s a slower process that will be detected in time with routine monitoring.
I do wonder what role the e- antigen status and also the type of mutation play in the outcome of stopping treatment, and I think we need more research on this.
Given the still quite high cost of ongoing treatment, as well as the side effects of at least some antivirals, I think it’s important for people to be aware that for many, if not most, lifetime treatment is not the absolute necessity we were told it was when these meds first became available for HBV.
Yes, there are many studies looking into this (many are summarised here: Challenges With Stopping Long-term Nucleos(t)ide Analogue Therapy in Patients With Chronic Hepatitis B), in some studies 80% respond as you have with “sustained virological response”. However, in other studies 0% responded like this.
We are still working out what factors might be responsible for this. We have some general preliminary observations and sort of see that it’s less likely you will respond well if you have high HBsAg or HBeAg-postive, if you’re Asian, or have cirrhosis.
There’s also the risk of adverse outcomes like liver failure or death: there was one study where 4% of people who stopped nucs had liver decompensation. This is why it’s very important to have very close monitoring during and ongoing monitoring in the years after the discontinuation.
Hello I’m a new member I have registered few months a go I’m a chronic hepatitis b patient I was diagnosed last year during my pregnancy and since then I started this journey it wasn’t easy for me I couldn’t believe I had it I cried my eyes out but I later accepted it.
I have been monitoring my my liver and viral load since I gave birth and my doctor recently requested I go for fribroscan and it showed I have stage 1 frobrosis I started taking tenofovir last two weeks and I just found out I’m pregnant please I’m scared should I continue the treatment or I shout stop I heard tenofovir disproxil fumarate has effects on pregnancy
Hi @sadia,
Welcome to the forum and sorry to hear about the stress you’ve been under about your diagnosis. It is good that you are seeing a doctor about it though and it got caught before too much liver damage had occurred.
Regarding your question, you need to talk to your doctor before changing anything about how you take your medications. However, tenofovir is considered safe and is the recommended antiviral for those who are pregnant (e.g. see the guidelines from the Gastroenterological Society of Australia, recommendation 22 - https://www.gesa.org.au/public/13/files/Education%20%26%20Resources/Clinical%20Practice%20Resources/Hep%20B/HBV%20consensus%20Mar%202022%20Updated.pdf#page=14).
Thomas
Thank you for the feedback
But can I continue taking it even in early pregnancy without causing any effects on the fetus?
And please in my case is the the fibrosis reversible?
Hi @sadia,
Multiple studies have shown that there is no increased risk to the safety of mother or child when taking tenofovir early in pregnancy:
Also, F1 fibrosis is generally considered to be reversible.
Hope this helps,
Thomas
Please is it true that tenofovir DF causes birth defects and stillbirth please I need more information about it I read it online I’m scared because I’m currently pregnant and I’m taking tenofovir df o was on medication when I got pregnant so my gastroenterologist said must continue because discontinuation can cause hepatic flare I’m scare I don’t want to lose my child 
Dear Sadia,
As mentioned above, there is no reported risk for birth defects and stillbirth associated with tenofovir. This is the recommended treatment for HBV in pregnant mothers because of this safety aspect. Indeed, it will help ensure that your child is protected from HBV upon birth.
Thomas