Can hepatitis B surface antigen (HBsAg) positive turn negative?

In general, a positive result for hepatitis B item 1 and item 5 usually refers to the presence of hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc). Whether these markers can become negative depends on a comprehensive assessment of disease severity, treatment approach, and individual physical condition, as detailed below:

For individuals who are positive for both HBsAg and anti-HBc and are in the acute phase of infection, with mild abnormalities in liver function tests, strong immune systems, and who receive standardized antiviral therapy, there is a possibility of seroclearance. In such cases, the body's immune system may work together with medication to eliminate the virus. After treatment, some patients may gradually lose HBsAg, and anti-HBc may also turn negative as the condition improves. Regular monitoring of viral load is necessary to evaluate treatment efficacy.

However, if the infection has become chronic—lasting more than six months—with persistently high viral load or has progressed to cirrhosis, the likelihood of achieving seroclearance is extremely low. In these patients, the virus is often integrated into liver cells, making complete eradication difficult with current treatments. Overly pursuing seroclearance may lead to delays in receiving proper standard care.

Daily management should include strict abstinence from alcohol, avoiding staying up late and excessive fatigue, and maintaining a light diet rich in high-quality protein. Patients must take prescribed medications on time, undergo regular follow-up tests for liver function and viral markers, and maintain emotional stability to prevent disease progression.