{
  "abstract": "We read with interest the recent article by Hui et al, who characterised quantitative hepatitis B surface antigen (qHBsAg) profiles, described longitudinal qHBsAg trajectories and identified factors associated with HBsAg seroclearance in a large cohort of patients with chronic hepatitis B (CHB).1 The qHBsAg, as a key marker of chronic HBV infection, is closely associated with treatment response and long-term prognosis.2–4 Hui et al reported that over 40% of patients with CHB had serum qHBsAg levels >1000 IU/mL,1 which was associated with a low likelihood of achieving HBsAg seroclearance with current antivirals and with suboptimal responses to novel antivirals.1 5–7 Moreover, the alanine aminotransferase (ALT) to qHBsAg ratio has been proposed as a novel predictor of both HBsAg seroclearance and qHBsAg trajectories, with patients having an ALT/qHBsAg ratio ≥0.27 demonstrating a significantly higher likelihood of achieving HBsAg seroclearance regardless of antiviral treatment.1 However, this study is limited by single-centre design and the relatively older age of included patients (mean age 48 years). Using a large, real-world, multicentre cohort of younger patients with CHB, we assessed the prevalence and clinical characteristics of patients across different qHBsAg levels and ALT/qHBsAg ratios. Moreover, we evaluated the association between ALT/qHBsAg ratios and HBsAg seroclearance in both treated and untreated patients.",
  "authors": [
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China",
        "Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Jian Wang"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China"
      ],
      "name": "Tao Fan"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, China"
      ],
      "name": "Li Zhu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Shaoqiu Zhang"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China"
      ],
      "name": "Ye Xiong"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, Jiangsu, China"
      ],
      "name": "Chao Jiang"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Juan Xia"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Renling Yao"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Xiaomin Yan"
    },
    {
      "affiliations": [
        "Department of Clinical Laboratory, Huai'an No. 4 People’s Hospital, Huai’an, Jiangsu, China"
      ],
      "name": "Xingxiang Liu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, China"
      ],
      "name": "Chuanwu Zhu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China",
        "Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Chao Wu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China",
        "Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China"
      ],
      "name": "Rui Huang"
    }
  ],
  "title": "Profiles of quantitative hepatitis B surface antigen in patients with chronic hepatitis B",
  "uid": "27179461-a626-56e6-9d04-29cc32973c72"
}