Abstract

During the natural history of chronic hepatitis
B virus (HBV) infection, the loss of serum hepatitis B e
antigen (HBeAg) and the development of anti-HBe antibodies
(HBeAg seroconversion) mark a transition from the
immune-active phase of disease to the inactive carrier state.
This review examines the evidence from natural history
and cohort studies on the relationship between HBeAg
seroconversion and disease progression. The role of
HBeAg seroconversion as an important milestone in the
management of HBeAg-positive patients with chronic
hepatitis B (CHB), as well as the advantages and disadvantages
of administering a finite course of therapy for
HBeAg-positive CHB, is also discussed. The evidence
from natural history and cohort studies indicates that
spontaneous or treatment-induced HBeAg seroconversion
is associated with lower rates of disease progression to
cirrhosis and hepatocellular carcinoma, a potential of
hepatitis B surface antigen seroconversion, and improved
survival rates. Updated guidelines developed by major liver
associations recommend stopping oral therapy for HBeAgpositive
patients who achieve sustained HBeAg seroconversion
with polymerase chain reaction-undetectable HBVDNA
on two separate occasions for 6 or more months
apart, taking into consideration the individual’s clinical and
virologic response to therapy, as well as the severity of
liver disease. Thus, early induction of HBeAg seroconversion
with interferon-based therapy or oral nucleos(t)ide
analogues has important clinical and socioeconomic
implications for the management of CHB.

• 附件：1 HBeAg seroconversion as an important end point in the treatment.pdf