BACKGROUND AND AIMS In chronic hepatitis B virus (HBV) infections, hepatitis B surface antigen (HBsAg) seroclearance reportedly occurs at a rate of 0.50-2.26%. Several factors were suggested to be associated with seroclearance including age and HBeAg negativity. However, there are few studies evaluating whether HBV DNA levels are an independent predictor of HBsAg seroclearance. The aim of this study was to evaluate the annual HBsAg seroclearance rate and its predictors including serum HBV DNA levels in HBeAg-negative chronic hepatitis B patients.

METHODS We included 880 HBeAg-negative chronic hepatitis B patients who underwent an evaluation of baseline serum HBV DNA levels. We reviewed the electronic charts for baseline clinical, biochemical, and virological factors.

RESULTS The median age was 50 years, and the follow-up duration was 31 months. The annual rate for the HBsAg seroclearance was 1.8%. In multivariable analysis, the probability of HBsAg seroclearance was positively associated with old age (p = 0.046), with a sustained inactive phase rather than the occurrence of HBeAg-negative hepatitis (p = 0.041), and with an initial HBV DNA level <2,000 IU/ml (p = 0.001).

CONCLUSION The annual rate for the HBsAg seroclearance in HBeAg-negative chronic hepatitis B patients was 1.8%. Old age, sustained inactive phase, and low levels of HBV DNA were independent predictors of HBsAg seroclearance.