Evidence map›Paper›PMID 41686332›Full record

SynthesisHepatology international2026

The incidence of spontaneous HBsAg loss in patients with different baseline HBsAg levels: a systematic review and meta-analysis.

Shulan Sui, Hanqiang Li, Ruirui You, Jiqin Wu, Jibing Xin, Tingting Zhao, Yan Miao, Yanfei Ren, Yueting Qu, Xiangyue Wang and 7 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Shulan Sui *Department of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Hanqiang Li *Department of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong, China.
Ruirui You *Department of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Jiqin WuDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Jibing XinFudan University Library, Shanghai, China.
Tingting ZhaoDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Yan MiaoDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Yanfei RenDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Yueting QuDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Xiangyue WangDepartment of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong, China.
Xu LiuDepartment of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong, China.
Wenting HuangDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Ting LiDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Jun YingFudan University Library, Shanghai, China.
Wenhong ZhangDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China.
Xi LiuDepartment of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-Sen University, No. 52 Meihua East Road, Zhuhai, Guangdong, China. liuxi26@mail.sysu.edu.cn.
Qiran ZhangDepartment of Medicine, National Medical Center for Infectious Diseases, Shanghai, China. zhangqiran@fudan.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsHepatitis B surface antigen (HBsAg) seroclearance is an ideal treatment end point in chronic hepatitis B (CHB), linked to improved clinical outcomes. Baseline HBsAg level is a key predictor, but pooled evidence on the annual incidence of spontaneous HBsAg clearance in untreated CHB patients, stratified by baseline HBsAg levels, is lacking. We conducted a systematic review and meta-analysis to quantify this incidence.

methodsSix databases were searched for cohort studies and randomized trials of untreated adult CHB patients reporting baseline HBsAg levels and annual clearance rates. Data were collected and analyzed using the random-effects model.

resultsTen studies involving 17,439 patients with 16,134.82 person-years of follow-up were included. The overall pooled annual incidence of spontaneous HBsAg clearance was 1.52% (95% CI 1.11-1.98%), with high heterogeneity (I

conclusionsSpontaneous HBsAg clearance remains a relatively uncommon event in untreated CHB patients, yet its incidence is highly dependent on baseline HBsAg levels, with a higher likelihood of clearance at lower levels. These findings provide benchmark data for clinical decision-making regarding antiviral therapy initiation and for the design of future clinical trials. Current evidence is limited, underscoring the need for more high-quality, finely stratified studies in this area.

Indexed as

Hepatitis B, ChronicHepatitis B Surface AntigensAdultAntiviral AgentsHepatitis B virusHumansIncidenceAntiviral AgentsHepatitis B Surface AntigensBaseline HBsAgChronic hepatitis BHBsAg lossHBsAg reductionHBVMeta-analysisSpontaneous HBsAgStratificationTherapeutic end pointsUntreated

Identifiers

PMID41686332

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.