Advances in Viral Markers for Predicting Functional Cure of Chronic Hepatitis B

ABSTRACT First‐line antiviral therapies for chronic hepatitis B include nucleos(t)ide analogues and pegylated interferon‐α. However, neither therapy can completely eliminate hepatocellular covalently closed circular DNA, making complete cure currently unattainable. Functional cure, primarily defined as sustained hepatitis B surface antigen loss, is the optimal therapeuticgoal for chronic hepatitis B. Although combined or sequential nucleos(t)ide analogues/pegylated interferon‐α regimens improve hepatitis B surface antigen seroclearance rates, only a minority of patients achieve this outcome. Therefore, quantification of hepatitis B virus viral markers using standard clinical assays is essential for predicting functional cure before treatment and during therapeutic monitoring. Early identification of patients likely to achieve hepatitis B surface antigen may help loss improve cure rates and potentially reduce medical costs. This review summarizes recent advances in viral markers for predicting functional cure in chronic hepatitis B, evaluates the predictive performance of individual markers, and provides evidence to optimize clinical treatment strategies.