Nonadherence to Antiviral Therapy Leading to Severe Hepatic Decompensation in a Patient With Chronic Hepatitis B

ACG Case Reports Journal 2026 Open access

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Authors: Saeed Ahmad, Sadia Paracha, Rahmat Ali, Syed Muhammad Ali Akbar, Muhammad Ahsan Asif, Muhammad Saeed, Roma Bai, Hafiz Muhammad Tousif Afzal, S Shah, Daryl T. Y. Lau
DOI: 10.14309/crj.0000000000001999
Cited by: 1
References: 19

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.

Fields of Study & Subjects

Hepatitis B Virus Studies Hepatitis C virus research HIV/AIDS drug development and treatment

Publication details

Journal / source
ACG Case Reports Journal
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
13
Issue
2
Pages
e01999–e01999
Publication date
1 February 2026
Language
EN