{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:11:58Z","timestamp":1785845518423,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH22HC1001"],"award-info":[{"award-number":["JPMH22HC1001"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["JPMH19HC1001"],"award-info":[{"award-number":["JPMH19HC1001"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Hepatitis B surface antigen (HBsAg) seroclearance is widely regarded as a functional remission of chronic hepatitis B virus (HBV) infection. However, HBV covalently closed circular DNA (cccDNA) may persist in hepatocytes, posing a risk of reactivation even years after seroclearance. We aimed to determine the incidence, clinical context, and virological features of HBV reactivation in a large, population\u2010based cohort from a geographically isolated island region of Japan with a high HBV prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 1978 and 2008, 34,517 residents of the northern Goto Islands underwent community\u2010based HBsAg screening, identifying 1045 individuals with chronic HBV infection (3.0% prevalence). Among them, 177 achieved spontaneous HBsAg seroclearance and were followed for a median of 6.3\u00a0years (1500 person\u2010years). Age\u2010 and sex\u2010matched controls were selected from HBsAg\u2010negative residents (3043 person\u2010years). Reactivation\u2010related events were defined as reappearance of HBsAg after confirmed seroclearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HBV reactivation\u2010related events occurred in 4 of 177 patients (2.3%), corresponding to 27 per 10,000 person\u2010years, whereas none occurred among 354 matched controls. All HBsAg reappearance cases had cirrhosis or hepatocellular carcinoma at baseline. One patient developed a hepatitis flare with high\u2010level viremia and HBeAg reappearance. Viral sequencing demonstrated 99.1% similarity between baseline and reactivated strains, confirming reactivation rather than reinfection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reactivation\u2010related events after HBsAg seroclearance were rare in this population\u2010based cohort. These findings suggest that HBsAg seroclearance may not necessarily indicate complete viral eradication and that careful long\u2010term monitoring may be warranted, particularly in patients with advanced liver disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70146","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:15:48Z","timestamp":1773004548000},"page":"944-955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence and Characteristics of HBV Reactivation\u2010Related Events Following HBsAg Seroclearance: Long\u2010Term Follow\u2010up of a Population\u2010Based Cohort in Japan"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8876-4440","authenticated-orcid":false,"given":"Kazumi","family":"Yamasaki","sequence":"first","affiliation":[{"name":"Clinical Research Center NHO Nagasaki Medical Center  Omura Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Shirahama","sequence":"additional","affiliation":[{"name":"Kamigoto Hospital  Shin\u2010Kamigoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yasaka","sequence":"additional","affiliation":[{"name":"Tsushima Hospital  Mitsushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Kamigoto Hospital  Shin\u2010Kamigoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Mizokami","sequence":"additional","affiliation":[{"name":"Molecular &amp; Cellular Glycoproteomics Research Group Cellular and Molecular Biotechnology Research Institute National Institute of Advanced Industrial Science &amp; Technology  Tsukuba 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