Clinical and laboratory characteristics of patients with hepatitis B surface antigen seroclearance: a single-centered retrospective study in vietnam

Introduction: HBsAg seroclearance is considered the optimal therapeutic endpoint in patients with chronic hepatitis B (CHB), and associates with reduced risks of cirrhosis and hepatocellular carcinoma. Methods: A descriptive case series study was conducted among 133 patients with CHB who achieved HBsAg loss and were followed at the Hepatitis Clinic, University Medical Center at Ho Chi Minh City, from January 2023 to September 2025. Clinical data, including time to HBsAg loss, were retrospectively collected from the time of initial HBV diagnosis. Results: The study population included 60.9% males, with a mean age at disease detection of 41 ± 12 years, and 94.7% diagnosed by health screening. HBeAg-negative was confirmed in 66.2% of cases, and 23.3% had ALT ≥2 ULN at the time of diagnosis. The mean age at HBsAg loss was 53 ± 11 years. A total of 48.9% achieved HBsAg loss following antiviral therapy, with a mean treatment duration of 9 ± 3.6 years. At the time of HBsAg loss, 18.8% had anti-HBs ≥10 mIU/mL. Cumulative anti-HBs seroconversion reached 47% at 5 years, as estimated by the Kaplan–Meier method, with patients censored at their last follow-up visit. No new cases of cirrhosis or hepatocellular carcinoma were recorded during a mean follow-up of 3.1 ± 2.6 years after patients lost HBsAg; however, this duration may be insufficient to assess long-term outcomes, such as HCC fully. Conclusions: HBsAg seroclearance was observed predominantly among middle-aged male HBeAg-negative individuals in this cohort; however, these findings are descriptive and should not be interpreted as predictors. Although liver function remained stable, the relatively short follow-up duration limits conclusions on long-term complications. These findings provide critical real-world data to guide long-term patient monitoring after HBsAg loss in Vietnam.