Chronic hepatitis B virus (HBV) infection is a serious problem owing to its worldwide distribution and potential adverse sequelae that include cirrhosis and/or hepatocellular carcinoma. Current antiviral therapies have much improved outcomes, but few patients achieve the ultimate goal of hepatitis B surface antigen (HBsAg) loss (functional cure). As hepatitis B e antigen (HBeAg)-negative chronic HBV infection is the final phase prior to HBsAg loss, the management of patients in this phase together with quantification of HBsAg has attracted increasing clinical and research interest. This Review integrates the findings from research in HBsAg kinetics and discusses how they might inform our understanding and management of HBeAg-negative chronic HBV infection. Studies have shown that HBsAg levels are highly predictive of the presence of inactive HBV infection and that serial changes in HBsAg levels might predict HBsAg loss within 1–3 years. Data also suggest that quantitative HBsAg monitoring is important during hepatitis flare and antiviral therapy, especially in the timing of the decision to stop therapy and to start off-therapy retreatment. These findings have shed new light on the natural course of HBV infection and might lead to optimization of the management of HBeAg-negative chronic HBV infection and contribute to the paradigm shift from indefinite to finite therapy for patients with HBV infection.

慢性乙型肝炎病毒 (HBV) 感染是一个严重的问题，因为它的全球分布和潜在的不良后遗症包括肝硬化和/或肝细胞癌。目前的抗病毒疗法已经大大改善了结果，但很少有患者达到乙型肝炎表面抗原 (HBsAg) 丧失（功能性治愈）的最终目标。由于乙型肝炎 e 抗原 (HBeAg) 阴性慢性 HBV 感染是 HBsAg 消失之前的最后阶段，因此该阶段患者的管理以及 HBsAg 的定量已经引起了越来越多的临床和研究兴趣。本综述整合了 HBsAg 动力学研究的结果，并讨论了它们如何帮助我们理解和管理 HBeAg 阴性慢性 HBV 感染。研究表明，HBsAg 水平高度预测非活动性 HBV 感染的存在，并且 HBsAg 水平的连续变化可能预测 1-3 年内 HBsAg 的消失。数据还表明，定量 HBsAg 监测在肝炎发作和抗病毒治疗期间很重要，尤其是在决定停止治疗和开始停止治疗再治疗的时机。这些发现为 HBV 感染的自然过程提供了新的线索，并可能优化 HBeAg 阴性慢性 HBV 感染的管理，并有助于将 HBV 感染患者的治疗从无限期治疗转变为有限治疗。特别是在决定停止治疗和开始治疗后复治的时机。这些发现为 HBV 感染的自然过程提供了新的线索，并可能优化 HBeAg 阴性慢性 HBV 感染的管理，并有助于将 HBV 感染患者的治疗从无限期治疗转变为有限治疗。特别是在决定停止治疗和开始治疗后复治的时机。这些发现为 HBV 感染的自然过程提供了新的线索，并可能优化 HBeAg 阴性慢性 HBV 感染的管理，并有助于将 HBV 感染患者的治疗从无限期治疗转变为有限治疗。