I acquired Hep B at birth and in the US, my doctors only run qualitative tests, so I decided to get quantitative tests done during trips to China. My 2025 results from China were consistent with my US labs. But my 2026 test from a couple of weeks ago shows my HBeAg dropping below the reference range for the first time! I still don’t have the antibody, but with HBeAg going down, do I actually stand a chance at a functional cure?
Here are the numbers:
Marker
2025 Results
2026 Results (Recent)
Reference
HBsAg
< 20 IU/ml
0.6 IU/ml
≤ 0.05
HBeAg
1.06 COI
0.829 COI (Negative!)
< 1.0
HBV RNA
< 300 copies/ml
< 1.00E+02 copies/ml
Limit of detection
(Note: The 2025 lab didn’t provide a granular HBsAg reference, but the 2026 reference was ≤ 0.05).
Hi, HbeAg loss is usually not an indicator of functional cure and only indicates that the virus has stopped producing HbeAg due to a mutation. It’s the HBsAg loss that is considered as a functional cure, but it looks in your case HbsAg as well as HBV RNA are extremelly low , so you might be on a road to a cure! Good luck!
Hi I am kinda in the same situation as you but my body has developed antibodies at the envelope level (HBeAg). I don’t have antibodies for the surface antigen yet(HBsAg). My brother just developed antibodies for the surface antigen (HBsAg) after developing antibodies for HBeAg. So that is consider a functional cure.
I agree with @Ace. Generally, people clear HBeAg before clearing HBsAg, but then again, some people lose eAg for decades before losing sAg (or they never lose sAg). But your levels are extremely low, so there is reason to be hopeful!
Could it be that the ref range is different? I noticed that the U.S. ref range is negative vs in China it’s a specific low value (<1). China has a lot more HepB patients and it’s hard to imagine their tests are less accurate/sensitive than the U.S. hospital.
Yes, but based on your previous test your HbsAg was very low, which sometimes means you could be close to clearing the virus. And you are right, doctors would normally just request a qualitative Hbsag test, But if you ask for a quantitative test maybe your doctor would be willing to order.
