Monitoring B cell Immune Responses Following Discontinuation of Treatment in Hepatitis B Infection
By
Sabela Lens
Alice R Burton
Jessica Davies
Maelle Locatelli
Mireia García-López
Anna Pocurull
Anna Jeffery-Smith
Nikolai Novikov
Simon P Fletcher
Xavier Forns
Sofía Pérez-del-Pulgar
Mala K Maini
August 1, 2026
Clinical Scorecard: Monitoring B cell Immune Responses Following Discontinuation of Treatment in Hepatitis B Infection
At a Glance
Category Detail
Condition Chronic Hepatitis B (CHB) Key Mechanisms B cell immunity and memory B cell (MBC) function following nucleos(t)ide analogue (NA) therapy discontinuation. Target Population Patients with HBeAg-negative chronic hepatitis B who have achieved complete virological control under NA therapy. Care Setting Clinical research setting involving prospective study design.
Key Highlights
Prolonged NA therapy equalizes frequencies of HBc and HBs-specific MBC. PD-1 expression of HBs-MBC decreases only after treatment withdrawal. Higher activated MBC and plasmablasts observed in patients achieving HBsAg loss. Class-switched HBc-MBC increases temporally with withdrawal flares. Need for larger studies to explore B cell biomarkers for predicting NA withdrawal outcomes. Guideline-Based Recommendations
Diagnosis
Assess serum quantitative hepatitis B surface antigen (qHBsAg) levels at the time of NA discontinuation. Management
Consider NA withdrawal in HBeAg-negative CHB patients with low qHBsAg levels. Monitoring & Follow-up
Monitor for life-threatening ALT flares and viral rebound post-NA withdrawal. Risks
Risk of life-threatening ALT flares and viral rebound upon discontinuation of NA therapy. Patient & Prescribing Data
21 patients with HBeAg-negative CHB under prolonged NA therapy.
Functional cure rates of up to 20% observed following NA withdrawal.
Clinical Best Practices
Utilize biomarkers to predict responders to NA therapy discontinuation. Monitor immune responses post-NA withdrawal to guide therapeutic decisions. Related Resources & Content
