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Existing data suggest that lower HBsAg levels at baseline may be associated with a better treatment response. Takkenberg et?al. [21] have analysed the predictive value of baseline HBsAg levels in 48 patients with HBeAg-negative CHB who received PEG-IFNa and adefovir (ADV) for 48?weeks and were followed for 2?years thereafter. Baseline HBsAg was the only independent predictor of HBsAg loss at week 144 (odds ratio: 0.22, P?=?0.01). Specifically, 75% of patients with HBsAg loss had a baseline HBsAg level below 400?IU/ml corresponding to a positive predictive value of 100% and a negative predictive value (NPV) of 95%. However, since HBsAg levels show significant variations during the natural course of chronic http://www.selleck.cn/products/Everolimus(RAD001).html HBV infection and perhaps among different HBV genotypes, this variability http://www.selleckchem.com/products/ch5424802.html could have important implications for using quantitative HBsAg as a marker for predicting treatment responses [22, 23]. In support of this, a recent study by Brunetto et?al. [24] provides new insight into the influence of HBV genotypes on both on-treatment HBsAg kinetics and end of treatment HBsAg levels that are associated with a SVR. Their results show that baseline HBsAg levels were significantly higher for A than B, C or D genotypes. Moreover, on-treatment HBsAg kinetics varied between genotypes. Therefore, the authors have suggested genotype-specific time frames and specific end-of-treatment thresholds to improve response-guided treatment of HBeAg-negative CHB. A decrease in HBsAg levels during PEG-IFN�� treatment could be also useful as a predictor of off-treatment SVR and/or HBsAg clearance in patients with HBeAg negative CHB. In a relatively small study including 48 patients with HBeAg-negative CHB who were treated with PEG-IFNa for 48?weeks, there was a 89 and 92% chance of SVR if HBsAg declined >0.5 log10 at week 12 and >1 log10?IU/ml at week 24 respectively. In contrast, in patients who failed to achieve this decline, the chance of a SVR defined as undetectable ( http://www.selleckchem.com/products/azd9291.html and results were not confirmed in another study of PEG-IFN�� in HBeAg-negative CHB [26]. Brunetto et?al. [27] showed that HBsAg level