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Background:We aimed to evaluate the usefulness of serum hepatitis B virus core-related antigens (HBcrAg) for predicting hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B patients treated with conventional interferon (IFN) alfa-2b or pegylated IFN.Methods:Fifty-eight patients were enrolled:29 for the training group and 29 for the validating group.HBcrAg was measured at baseline,week 12,end of the treatment,and 12-and 24-week follow-ups.Sixteen patients in the training group were enrolled in the long-term follow-up (LTFU),during which time the dynamics of the HBcrAg was monitored.Results:The serum HBcrAg level gradually declined during treatment among the HBeAg seroconversion patients of the training group (from baseline,week 12,end of the treatment,12-week follow-up to 24-week follow-up were 110,245 kU/ml,3760 kU/ ml,7410 kU/ml,715 kU/ml,200 kU/ml,respectively).HBcrAg ＜19,565 kU/ml at week 24,HBcrAg ＜34,225 kU/ml at 12-week follow-up,and HBcrAg decrease ≥0.565 log10 kU/ml from the baseline to the end of treatment (EOT) had negative predictive values (NPVs) of 100％ for HBeAg seroconversion at the end of follow-up,whereas the positive predictive values (PPVs) were 30.77％,26.67％,and 25.00％,respectively.The patients with HBeAg seroconversion at the end of 24-week follow-up remained in seroconversion during the LTFU,during which time their serum HBcrAg levels steadily declined or even became undetectable,ranging from 0 to 2.1 kU/ml.Conclusions:Effective antiviral treatment can decrease HBcrAg levels in the serum.The NPVs of HBcrAg for predicting HBeAg seroconversion at 24-week follow-up was 100％,but the PPVs were not satisfactory (all ＜31％).The serum HBcrAg levels of the patients with HBeAg seroconversion at the end of the 24-week follow-up steadily declined or even became undetectable during the LTFU.