We would like to respond to Dr Pariente's letter, which addresses our recently reported results regarding the seroclearance of HBV seromarkers and subsequent risk for hepatocellular carcinoma (HCC).1 ,2 Unfortunately, his comments are based on serious misunderstandings of our findings.

First, he suggests that there may be underestimation of the protective roles of marker seroclearance, since incidence rates of HCC were measured from baseline, and that the duration of seromarkers’ positivity would be a better indicator of HCC risk. In order to truly measure the effect of HBV DNA and Hepatitis B surface Antigen (HBsAg) seroclearance on HCC incidence, we would need a large cohort of individuals followed up since birth for subsequent outcomes. However, this was not feasible in this study. Thus, left truncation that often occurs …