@article{Thursz:2026:10.1097/hep.0000000000001821,
author = {Thursz, M and Lemoine, M and Brown, A and Carey, I and Message, J and Kennedy, P and Forton, D and Wiselka, M and Aldersley, M and Prince, M and McPherson, S and Phillips, S and Chokshi, S and Burton, A and Maini, M and Christiaan, Botha J and Nastouli, E and Tsao, S and Falaschetti, E and Box, H and Habib, M and Agarwal, K},
doi = {10.1097/hep.0000000000001821},
journal = {Hepatology},
title = {Nucleos(t)ide withdrawal versus nucleos(t)ide withdrawal with adjuvant pegylated-interferon in HBeAg-negative hepatitis B virus infection (NUC-B trial)},
url = {http://dx.doi.org/10.1097/hep.0000000000001821},
year = {2026}
}

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TY  - JOUR
AB  - Background:Finite therapy resulting in sustained hepatitis B surface antigen (HBsAg) loss for patients with chronic HBV infection (CHB) is an important therapeutic goal. In patients with HBeAg-negative infection, nucleos(t)ide analog (NA) withdrawal may achieve HBsAg loss in 5%–20% of patients after 3 years. Pegylated interferon (PEG-IFNα) is a recognized treatment for CHB.Methods:NUC-B was a randomized, multicenter trial in NA-treated non-cirrhotic HBeAg-negative patients with CHB. Patients were allocated to either NA withdrawal alone (control) or NA withdrawal followed by a 16-week course of PEG-IFNα 180 μg weekly commencing 4 weeks after NA cessation (PEG-IFNα). The primary endpoint was HBsAg loss at 3 years.Results:The target recruitment of 240 patients was not achieved. In all, 156 patients, 82 to the control arm, 74 to the PEG-IFNα arm, were recruited between 2017 and 2021; median age 45 years, 24% female, HBV genotypes—A 16%, B 6%, C 4%, D 24%, E 22%, other 1%, nd unknown 26%. At 3 years, 3% of patients in the control arm and 14% of patients in the PEG-IFNα arm lost HBsAg (OR 5.39; 95% CI (1.11, 26.19); p=0.037). In the control arm, 34.9% of patients returned to NA therapy compared with 28.4% in the PEG-IFNα arm. Exaggerated flares occurred in 27.9% of patients in the control arm compared with 13.4% in the PEG-IFNα arm.Conclusions:The use of adjuvant PEG-IFNα therapy after withdrawal of NA therapy increases the rate of HBsAg loss while simultaneously reducing the number of exaggerated flares.
AU  - Thursz,M
AU  - Lemoine,M
AU  - Brown,A
AU  - Carey,I
AU  - Message,J
AU  - Kennedy,P
AU  - Forton,D
AU  - Wiselka,M
AU  - Aldersley,M
AU  - Prince,M
AU  - McPherson,S
AU  - Phillips,S
AU  - Chokshi,S
AU  - Burton,A
AU  - Maini,M
AU  - Christiaan,Botha J
AU  - Nastouli,E
AU  - Tsao,S
AU  - Falaschetti,E
AU  - Box,H
AU  - Habib,M
AU  - Agarwal,K
DO  - 10.1097/hep.0000000000001821
PY  - 2026///
SN  - 0270-9139
TI  - Nucleos(t)ide withdrawal versus nucleos(t)ide withdrawal with adjuvant pegylated-interferon in HBeAg-negative hepatitis B virus infection (NUC-B trial)
T2  - Hepatology
UR  - http://dx.doi.org/10.1097/hep.0000000000001821
UR  - https://doi.org/10.1097/hep.0000000000001821
ER  - 

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