*5.1. When and Whom to Stop Long-Term NA Therapy?*

After reviewing the current literature, we suggest that NAs should be discontinued:


As already pointed above, predictors of post-NA relapse are lacking; however, Papatheodorid et al. showed an overview of biomarkers able to identify non-cirrhotic CHB patients who can safely discontinue NAs before HBsAg loss; HBsAg serum levels at NA discontinuation seem to be able to predict the clinical relapse, as already emerged from the meta-analysis of Liu Y et al. [53,56] (Table 2).


**Table 2.** Patients that should stop long-term NA therapy and when.

#### *5.2. Management of Patients after NA Cessation*

Concerning the management of patients after NAs cessation, liver function tests (serum ALT/AST, bilirubin and prothrombin time) should be monitored at week 6, week 12, week 18, week 24, and 3 monthly thereafter for the first 2 years. Weekly or biweekly tests are recommended in the case of elevation of ALT or AST > 5X ULN.

HBV DNA and HBsAg should be monitored every 3 months in the first year or in case of virologic relapse or clinical relapse and every 6–12 months afterward [6,58].
