Abstract: We report a rare case of HBsAg seroconversion after 7 years of entecavir therapy in a 48-year-old HBeAg-negative CHB male patient with chronic hepatitis B (CHB). After a poor response to a 48-week interferon-α 2b therapy, the patient received long-term entecavir therapy. Serum ALT levels became normal and HBV DNA viral load was undetectable at the 10th week after commencement of entecavir treatment, and seroconversion of HBsAg was detected after 7 years of entecavir therapy.