Background: Chronic hepatitis B infection progresses through distinct phases that reflect the dynamic interplay between the hepatitis B virus (HBV) and the host immune system. Exhausted CD8+ T cells are marked by increased PD-1 expression, while soluble PD-1 (sPD-1), a soluble form of the PD-1 receptor, regulates immune responses. Both sPD-1 and CD8+ T cells play critical roles in determining i…