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13. Should the e-antigen be used to determine the success/end point of treatment?

If you actually look at a lot of the Asian patients who have been infected a long time, they are already seroconverted to e-antibody positive and e-antigen negative, and their DNA level could still be very high. When I was on the FDA committee for the lamivudine approval hearing, I raised this point. For those with long-term chronic infection, using the e-antibody seroconversion may not be the best way to determine the endpoint of treatment, because a lot of people will already have this conversion, and they are still at high risk for liver cancer. For those with a recent infection, the seroconversion as endpoint works better. I think that in general, using the e-antigen conversion to assess the endpoint of treatment should be re-examined.