{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:34:30Z","timestamp":1792427670927,"version":"4.5.0"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although hepatitis B surface antigen (HBsAg) loss is considered the ideal therapeutic endpoint for the treatment of chronic hepatitis B virus (HBV) infection, its impact on clinical outcomes remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the impact of HBsAg loss on clinical outcomes following spontaneous and treatment\u2010related HBsAg loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PUBMED, Embase, the Cochrane library, and published abstracts through to May 2021 for studies that reported HBsAg loss, had &gt;1\u00a0year of follow\u2010up and reported at least one clinical outcome in adults with chronic HBV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 57 studies (258\u00a0744 HBsAg\u2010positive patients, 63\u00a0270 with HBsAg loss). Based on 24 studies including 160\u00a0598 patients with and without HBsAg loss, HBsAg loss was associated with a non\u2010significant 23% relative risk reduction of developing hepatocellular carcinoma (HCC) compared to those who remained HBsAg\u2010positive (RR\u00a0=\u00a00.77; 95% CI: 0.38\u20101.57). In subgroup meta\u2010analysis of 10 studies, treatment\u2010related HBsAg loss was associated with a non\u2010significant higher pooled proportion of HCC (0.94%) compared to spontaneous HBsAg loss (0.45%). HCC development after HBsAg loss was significantly higher in males, those with underlying cirrhosis, and those with a family history of HCC. HBsAg loss was associated with lower pooled proportions of incident cirrhosis, hepatic decompensation, overall and liver\u2010related mortality compared to no HBsAg loss. Substantial heterogeneity was noted across studies for all outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HBsAg loss is associated with a reduced risk of clinical outcomes. However, several shortcomings in the published studies prevent a more definitive conclusion on the potential benefits of HBsAg loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.16659","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T04:39:55Z","timestamp":1638333595000},"page":"8-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Systematic review with meta\u2010analysis: the impact of functional cure on clinical outcomes in patients with chronic hepatitis B"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-5023","authenticated-orcid":false,"given":"Anusha","family":"Vittal","sequence":"first","affiliation":[{"name":"Liver Diseases Branch National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health  Bethesda Maryland 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