Nonadherence to Antiviral Therapy Leading to Severe Hepatic Decompensation in a Patient With Chronic Hepatitis B
Year: 2026
Type: article
Study design: Case Report
Abstract: Patients with chronic hepatitis B often require prolonged nucleos(t)ide analogue since functional cure is rarely achieved. Medication nonadherence can trigger life-threatening hepatitis B virus (HBV) reactivation. We report a 58-year-old Asian man with HBeAg-negative chronic hepatitis B and cirrhosis. After 10 years of entecavir therapy, he achieved undetectable HBV DNA and fibrosis regression, but quantitative hepatitis B surface antigen remained >1200 IU/mL. He self-discontinued medication and presented with severe hepatitis reactivation. Liver condition gradually improved on restarting nucleos(t)ide analogue. This case highlights that medication cessation with a high hepatitis B surface antigen titer can precipitate severe hepatitis and liver failure, even after long-term HBV DNA suppression.
Source: ACG Case Reports Journal
Authors: Saeed Ahmad, Sadia Paracha, Rahmat Ali, Syed Muhammad Ali Akbar, Muhammad Ahsan Asif, Muhammad Osama Saeed, Roma Bai, Hafiz Muhammad Tousif Afzal, Syed Bilal Shah, Daryl T.Y. Lau
Institutions: Beth Israel Deaconess Medical Center, Harvard University
Language: English
Topic: Hepatitis B Virus Studies
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128700902