What Are the Criteria for Clinical Cure of Hepatitis B?

The standard for clinical cure of hepatitis B is that after patients receive antiviral drug treatment, liver function test indicators return to normal, hepatitis B DNA turns negative, and clinical symptoms disappear. Subsequently, patients undergo regular follow-up visits to the hospital. If patients remain asymptomatic for two consecutive years or longer, they have achieved the criteria for a cure. Generally speaking, there are three main standards for hepatitis B cure.

This mainly refers to patients with hepatitis B in an active disease state. After treatment, their liver function is fully restored, and they are deemed clinically cured.

This treatment outcome applies to all hepatitis B populations, including virus carriers and patients with active hepatitis B. At this point, the main replication targets of the hepatitis B virus are tested as negative, liver function is normal, and this condition can be sustained for over a year.

Complete cure refers to the transformation of all antigen indicators of the hepatitis B virus to negative, and no presence of the hepatitis B virus is found in liver tissue examination. However, based on the current situation, complete cure is almost impossible. Most cases of chronic hepatitis B can achieve clinical and basic cure, but it takes a longer time and requires proper rest, reasonable nutrition, and medication.

Clinical studies have found that patients with positive hepatitis B surface antigen have a significantly higher risk of dying from cirrhosis or liver cancer compared to patients who have converted to negative. This is because positive hepatitis B surface antigen indicates that liver damage has not stopped, and even if transaminase levels are normal, antiviral treatment should continue with the goal of achieving serological conversion of hepatitis B surface antigen. Although some people have proposed goals for hepatitis B cure and eradication, there is still considerable controversy. According to the standards of authoritative institutions, most agree that controlling hepatitis B disease progression should be the main focus.

Currently, relying solely on the normalization of alanine aminotransferase levels as a criterion for antiviral treatment and liver inflammation activity has certain limitations. If serological conversion of hepatitis B surface antigen is observed alone as a criterion for cure, some patients may still develop cirrhosis or liver cancer in the future. However, reducing the viral load through antiviral treatment is beneficial for serological conversion of hepatitis B surface antigen.