To WP, et al. - Researchers sought to determine how hepatitis B core-related antigen (HBcrAg) levels after spontaneous HBeAg seroconversion are associated with hepatocellular carcinoma (HCC). They examined 207 chronic hepatitis B patients with documented time of HBeAg seroconversion for HBcrAg and HBsAg within 3 years (as baseline), at 5 years and 10 years after HBeAg seroconversion. During a median follow-up time of 13.1 (11.8–15.5) years 14 patients developed HCC (15-year cumulative incidence: 7%). Cox proportional hazards model revealed HCC development in independent correlation with age of HBeAg seroconversion older than 40 years (HR: 4.60), presence of baseline cirrhosis (HR: 6.23) and a higher baseline HBcrAg (HR: 1.75). A cut-off value of baseline HBcrAg level ≥ 5.21 log U/ml produced an AUROC of 0.74 with a negative predictive value of 97.7%.