Predicting Hepatitis B Virus (HBV) Surface Antigen Seroclearance in HBV e Antigen– Negative Patients With Chronic Hepatitis B: External Validation of a Scoring System

Background. Hepatitis B virus (HBV) surface antigen (HBsAg) seroclearance is the ultimate serological end point in chronic hepatitis B. This study aimed to develop and validate a prediction score for spontaneous HBsAg seroclearance in HBV e antigen (HBeAg)-negative patients with chronic hepatitis B due to HBV genotype B or C. Methods. The development cohort included 2491 untreated participants from the community-based REVEAL-HBV study, who were HBeAg negative, anti–hepatitis C virus negative, and cirrhosis free. The independent valida-tion cohort consisted of 1934 hospital-based individuals from the National Taiwan University Hospital. Clinical markers included in the model were age and serum HBV DNA and HBsAg levels. Cox proportional hazards regres-sion models were used to create the prediction model. Results. A prediction score ranging from 0 to 27 was developed. Predicted probabilities of 5- and 10-year HBsAg seroclearance ranged from 0.95 % to 30.49 % and from 2.58 % to 62.52%, respectively. When applied to the indepen