Can hepatitis B surface antigen disappear?

In general, hepatitis B surface antigen (HBsAg) may disappear, but it does not vanish in all cases. The likelihood and speed of its disappearance are closely related to the type of infection, the patient's immune status, and whether standardized treatment is received. A detailed analysis is as follows:

Hepatitis B virus (HBV) infection is classified into acute and chronic types. In cases of acute HBV infection, if the patient has a normal immune system, the body typically initiates an immune response within several months after infection, gradually eliminating the virus. As a result, HBsAg may become negative, and some patients may even develop hepatitis B surface antibodies, thereby acquiring immunity against HBV. In such cases, the disappearance of HBsAg indicates effective control or even resolution of the viral infection.

For chronic HBV infection, because the virus continuously replicates in the body and the immune system struggles to completely eliminate it, the probability of spontaneous HBsAg clearance is low, and most patients may carry the antigen for a long time. However, with advances in antiviral therapy, some chronic hepatitis B patients who receive standardized antiviral treatment may achieve HBsAg seroclearance—particularly those who respond well to treatment, maintain long-term suppression of viral replication, and experience gradual restoration of immune function.

Regardless of whether the infection is acute or chronic, the disappearance of HBsAg must be confirmed through regular testing of hepatitis B markers. Therefore, individuals infected with HBV should undergo regular follow-up examinations under medical guidance and follow individualized treatment and monitoring plans based on their clinical condition. Self-diagnosis or discontinuation of medication without medical advice must be avoided, so as to maximize the chance of achieving HBsAg seroclearance and protect liver health.