Optimizing off-treatment outcome predictions: The potential of time-varying HBcrAg and the need for more research

commenting on our recent study published in Clinical and Molecular Hepatology 2 regarding the role of time-varying hepatitis B core-related antigen (HBcrAg) in predicting clinical relapse (CR) for chronic hepatitis B (CHB) patients who discontinued tenofovir or entecavir.We agree that nucleos(t) ide analogue (NA) cessation is generally safe with hepatitis B surface antigen (HBsAg) seroclearance, 3 which is the only treatment endpoint widely acceptable across guidelines. 4,5nfortunately, it rarely occurs during long-term NA therapy. 6reatment discontinuation without first achieving HBsAg seroclearance invariably leads to recurrence of viremia and could precipitate hepatitis flare and even life-threatening acute on chronic liver failure. 7The strategy of finite NA therapy, therefore, cannot be practiced without thorough consideration of the conceivable benefits and potential risks for an