Spontaneous hepatitis B virus (HBV)
e antigen (
HBeAg) seroconversion is associated with reduced risk of liver-related complications, but is poorly understood. In this study, 113
chronic hepatitis B patients in the immune active
HBeAg-positive phase were followed up for 76 weeks. Based on the outcome of liver function,
HBeAg,
hepatitis B viral e antibody (anti-HBe) and HBV
DNA at week 76, 18 patients were classified as spontaneous
HBeAg seroconversion group (group A) and 95 patients were classified as non-spontaneous
HBeAg seroconversion group (group B). In multivariate logistic regression analysis, only week 28 HBV
DNA levels were used for the logistic regression equation, and the odds ratio was 0.505 (95% confidence interval (CI): 0.366-0.697). The areas under the receiver operating characteristic curve for HBV
DNA and
HBeAg levels at week 28 were 0.824 (P < 0.001, 95% CI: 0.720-0.927) and 0.832 (P < 0.001, 95% CI: 0.744-0.921), respectively. Based on the maximization of Youden's index, the optimal cutoff values of HBV
DNA and
HBeAg levels at week 28 were 3.84 log10 IU/ml and 1.53 log10 PEI-U/ml, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of HBV
DNA levels at week 28 were 50.0%, 97.9%, 81.8%, and 91.2%, respectively. The sensitivity, specificity, PPV, and NPV of
HBeAg levels at week 28 were 94.4%, 60.0%, 30.9%, and 98.3%, respectively. In conclusion, the dynamic monitoring of HBV
DNA and
HBeAg levels predicted accurately determines spontaneous
HBeAg seroconversion over the duration of 1 year.