Researchers from National Taiwan University Hospital and Academia Sinica have identified a simple blood marker that can reliably pinpoint chronic hepatitis B (CHB) patients at negligible risk of developing liver cancer.
The study, published in Gut, shows that patients with hepatitis B surface antigen (HBsAg) levels below 100 IU/mL face an annual hepatocellular carcinoma (HCC) risk of only 0.08%, comparable to the general population.
The findings come from two of the world’s largest HBV cohorts, ERADICATE-B and REVEAL-HBV, with more than 2,600 inactive CHB patients followed for over 25 years. Validation in the NTUH-iMD cohort confirmed that the low-risk threshold applies broadly.
Notably, about one-third (37%) of inactive CHB patients had HBsAg
“HBsAg liver cancer surveillance, which could transform public health strategies.”
Globally, 254 million people live with CHB, and over 1 million die annually, mainly from HCC. Current surveillance protocols are costly and often burdensome, especially in resource-limited settings. By adopting HBsAg
The authors emphasize that this threshold could also serve as a practical endpoint for upcoming HBV cure trials, bridging the gap between current antiviral therapy and functional cure.
More information:
Tai-Chung Tseng et al, Hepatitis B surface antigen level identifies patients with inactive chronic hepatitis B from Asia with HCC risk below surveillance threshold, Gut (2025). DOI: 10.1136/gutjnl-2025-334911
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