Abstract: Objective HBsAg loss represents clinical cure of hepatitis B. The aim of the present study was to investigate the HBsAg loss rate in inactive hepatitis B surface antigen carriers (IHCs) with extremely low HBsAg levels after peg-interferon α-2b (Peg-IFNα) short-term treatment. Methods Thirty-eight cases of IHCs were included in this study. They were treatment-nave and the average baseline HBsAg level were less than 15 IU/mL. According to the patients' willingness, they were divided into Peg-IFNα treatment group (N=12 cases) or control group (N=26 cases). The Peg-IFNα treatment group was subcutaneously injected with 180 μg/week of Peg-IFNα-2b for 24 weeks. The control group were followed up without treatment for a median of 55.7 (25.3±79.2) weeks. SPSS 25.0 software was used for statistical analysis., Chi-square test was used to compare the difference in HBsAg loss rate and HBsAg seroconversion rate between the two groups. Logistic regression was used to analyze the correlation between baseline characteristics, Peg-IFNα treatment and HBsAg loss. Results At 24 weeks, 83.3% (N=10) IHCs in the Peg-IFNα treatment group achieved HBsAg loss and 41.6% (N=5) IHCs achieved HBsAg seroconversion. 7.7% (N=2) IHCs in the control group had HBsAg loss and HBsAg seroconversion rate was 0. The HBsAg loss rate and HBsAg seroconversion rate in Peg-IFNα treatment group were statistically higher than that of the control group (P<0.05). By univariate analysis it was found that Peg-IFNα treatment significantly increased HBsAg clearance of IHCs (OR=60.00, 95% CI: 7.39 - 487.14). Conclusion Peg-IFNα short-term treatment for IHCs with extremely low HBsAg levels may significantly improve HBsAg loss rate and HBsAg seroconversion rate.

Key words: Inactive hepatitis B surface antigen carriers, Peg-interferon α-2b, Chronic hepatitis B, Extremely low HBsAg levels, HBsAg loss, Clinical cure