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Hepatitis B SerologyAka: Hepatitis B Surface Antibody, Hepatitis B Envelope Antigen, Hepatitis B Envelope Antibody, HBsAg, HBeAg, xHBsAb, xHBs IgG, xHBcAb, xHBc IgM, xHBc IgG, xHBeAb, xHBe IgM, xHBe IgG, Hepatitis B Surface Antigen, Hepatitis B Core Antibody

See Also
1. Hepatitis B
Detectable Antigens
1. Hepatitis B Surface Antigen: HBsAg
  1. First detectable agent in acute Hepatitis B Infection
  2. Present as early as incubation period
2. Hepatitis B Envelope Antigen: HBeAg
  1. Highly Infectious State
  2. Chronic Infection
Detectable Antibodies
1. Hepatitis B Surface Antibody: xHBsAb IgG
  1. Prior Hepatitis B Infection with Immunity
  2. Prior Hepatitis B Vaccine with Immunity
2. Hepatitis B Core Antibody: xHBcAb IgM and IgG
  1. Covers Convalescent period
    1. Window between HBsAg clearance to xHBsAb conversion
    2. HBsAg negative during this time
3. Hepatitis B Envelope Antibody: xHBeAb IgM and IgG
  1. Low Infectivity
  2. Predicts Hepatitis B Resolution
Course of serology progression
1. Stage 1: Immune Tolerant or Incubation Period
  1. Characteristics
    1. DNA replication very active in this stage
    2. Prolonged stage in newborns
    3. Asymptomatic (Serum Aminotransferases normal)
  2. Incubation (4-12 weeks)
  3. Late incubation (1-2 weeks)
    1. HBsAg Positive
2. Stage 2: Immune Response
  1. Characteristics
    1. Immune response causes hepatic cell destruction
      1. Serum Aminotransferases increased
    2. High risk stage for Chronic Hepatitis B progression
    3. Symptom flares may occur if immunocompromised
    4. Conversion to Stage 3
      1. Occurs in most adults rapidly
      2. Others convert 5-15% per year
  2. Early Acute
    1. HBsAg Positive
    2. HBeAg Positive
  3. Acute (2-12 weeks)
    1. HBsAg Positive
    2. HBeAg Positive
    3. xHBc IgM Antibody Positive
    4. xHBc IgG Antibody Positive
  4. Acute and Seroconversion (transitions into Stage 3)
    1. HBsAg Positive
    2. xHBc IgM Antibody Positive
    3. xHBc IgG Antibody Positive
    4. xHBe IgG Antibody Positive
3. Stage 3: Inactive carrier state (3-6 months)
  1. Characteristics
    1. Viral replication stops and transaminases normalize
    2. Possibly infectious and convalescent stage
    3. Conversion to Stage 4: 3% per year
  2. HBsAg Negative
  3. xHBc IgM Antibody Positive
  4. xHBc IgG Antibody Positive
  5. xHBe IgG Antibody Positive
4. Stage 4: Immune and Early Recovery
  1. xHBc IgG Antibody Positive
  2. xHBe IgG Antibody Positive
  3. xHBs IgG Antibody Positive
Resources
1. CDC NCI Viral Hepatitis B
  1. http://www.cdc.gov/ncidod/diseases/hepatitis/b
References
1. Murray (1999) Clin Microbiol Rev 12:351

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