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Hepatitis B — SCE Infectious Diseases MCQ

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ModerateHepatitisHepatitis BSCE Infectious Diseases

A 50-year-old man with chronic hepatitis B on Entecavir 0.5 mg daily has an undetectable HBV DNA for 3 years. He remains HBsAg positive with normal ALT. He asks whether he can stop treatment. What is the most appropriate advice?

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Correct answer: C — Continue Entecavir indefinitely

In HBsAg-positive chronic hepatitis B, nucleos(t)ide analogue therapy should generally be continued indefinitely. Stopping treatment while HBsAg remains positive carries a high risk of virological rebound and potentially severe hepatic flare, which can be fatal in cirrhotic patients. Treatment cessation may only be considered after confirmed HBsAg loss (functional cure) with anti-HBs seroconversion, which occurs in <5% of patients on NAs. Close monitoring is essential if treatment is discontinued.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections