We appreciate the comments by Chen et al 1 on our recent publication entitled 'Hepatitis B Surface Antigen Level Identifies Inactive Chronic Hepatitis B Patients from Asia with HCC Risk Below Surveillance Threshold'. 2 Their comments highlight the heterogeneity among patients with inactive chronic hepatitis B (CHB) and raise an important clinical question: Should nucleos(t)ide analogue (NA) therapy be initiated in patients with inactive CHB with high hepatitis B surface antigen (HBsAg) levels?
First, among the 58 patients with hepatocellular carcinoma (HCC) with baseline HBsAg >100 IU/mL, 27 (46.6%) had hepatitis B virus (HBV) DNA levels <200 IU/mL. Baseline HBV DNA levels were not associated with HCC development in patients with inactive CHB (table 2 of the original article).
Given this, we questioned whether viral rebound, rather than baseline viral load, might be associated with HCC development in this population. We thus analysed data from 2076 patients...
Gut (BMJ) published a clinical update in Research Highlights on 06 Mar 2026.
The item focuses on Reply to: 'Rethinking "inactive chronic hepatitis B": should we treat patients with high HBsAg levels?.
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