Evidence map›Paper›PMID 42797857›Full record

ArticleViruses2026

Immune Control, HBsAg Loss or Flare Requiring Liver Transplant-Diverse Outcomes After Stopping NUC Therapy.

Katarina Lund, Miriam Frankal, Anders Eilard, Joakim Bedner Stenbäck, Erik Alestig, Arno Furquim d'Almeida, Staffan Nilsson, Thomas Vanwolleghem, Johan Westin, Johan Ringlander and 2 more

Abstract read
In one paragraph

Article in Viruses, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Katarina LundDepartment of Infectious Diseases, Norra Älvsborg's Hospital, 461 73 Trollhättan, Sweden.
Miriam FrankalDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0000-0002-3346-6320
Anders EilardDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
Joakim Bedner StenbäckDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0009-0004-8831-9100
Erik AlestigDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
Arno Furquim d'AlmeidaViral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2610 Antwerp, Belgium.ORCID 0000-0002-8658-4742
Staffan NilssonDepartment of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg, 413 45 Gothenburg, Sweden.
Thomas VanwolleghemViral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 2610 Antwerp, Belgium.ORCID 0000-0002-0572-8741
Johan WestinDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0000-0002-2064-073X
Johan RinglanderDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0000-0002-8483-6504
Gustaf E RydellDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0000-0001-8093-2251
Magnus LindhDepartment of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.ORCID 0000-0002-8729-7462

Funding

Government of Sweden ALF-LUA 275108Swedish Cancer Society CAN 24 3586 Pj)
6 · The paper itself

Abstract

Hepatitis B surface antigen (HBsAg) loss is rarely achieved during long-term nucleos(t)ide analogue (NUC) therapy of chronic hepatitis B. Treatment discontinuation may lead to immune activation and HBsAg loss. In a prospective study, HBeAg-negative patients without liver cirrhosis stopped NUC therapy after a duration of at least 3 years. Follow-up for 2 years comprised monthly monitoring for the first six months. Twenty-five patients who discontinued therapy and six randomized controls who continued were included. After stopping NUC therapy, five patients (20%) developed an HBsAg seroclearance pattern, including four who lost HBsAg and one who achieved HBsAg below 1 IU/mL. Seven patients (28%) developed a state of immune control with persistently low HBV DNA and normal ALT. Six patients (24%) experienced severe flares requiring NUC re-initiation; all of them, including one with fulminant hepatitis necessitating liver transplantation, had detectable hepatitis B core-related antigen (HBcrAg) in serum at NUC discontinuation. The peak serum HBV DNA level strongly correlated with and preceded peak ALT. Thus, although half of the patients had favorable outcomes, there was a substantial risk of severe flares preceded by HBV DNA levels above 6 log

Indexed as

Antiviral AgentsHepatitis B, ChronicHepatitis B Surface AntigensLiver TransplantationAdultDNA, ViralFemaleHepatitis B virusHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAntiviral AgentsDNA, ViralHepatitis B Surface Antigenschronic hepatitis Bfollow-upHBsAgHBV DNAhepatitis B virusliver transplantationprospective study

Identifiers

PMID42797857
PMCPMC13611910

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.