CHRONIC HEPATITIS B SEROLOGY

Antigens HBsAg -Found on the surface of the intact virus and in serum as unattached particles -Earliest detectable marker in serum -indicates current Hepatitis B infection HBcAg -Found within the core of the intact virus -Not detectable in serum Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p

Antigens HBeAg -Readily detectable serologic marker of HBV infection -Appears shortly after HBsAg -Coincides w/high levels of virus replication -Indicates highly infective stage of HBV Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p.1935

Antibodies Anti-HBs -Antibody to HBsAg -Becomes detectable in serum after HBsAg disappears -indicates immunity to Hepatitis B infection -“protective antibody” Anti-HBc -Total antibody to HBcAg -Only serologic evidence of recent HBV infection during the “window period” -May indicate acute or chronic infection Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p

Antibodies Anti-HBc IgM -IGM antibody to HBcAg -Seen in the 1 st 6 months after acute infection -indicates recent acute Hepatitis B infection Anti-Hbc IgG -IgG antibody to HBcAg -predominates beyond 6 months - Seen in chronic HBV infection Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p

Antibodies Anti-HBe - Antibody to HBeAg - Signifies low infectivity Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p.1935

Chronic Hepatitis B Serologic Patterns HBs Ag Anti- HBs Anti- HBc HBeAgAnti- HBe Interpretation +-IgG+-Chronic Hepatitis B, High infectivity +-IgG-+Chronic Hepatitis B, Low infectivity Reference: 17 th Ed. Harrison’s Principles of Internal Medicine p.1943