II. Indications

  1. HIV Positive patients
  2. IV Drug Abuse
  3. Men who have Sex with Men
  4. Household contacts or sexual partners of infected persons
  5. People born in countries with high Prevalence of Hepatitis B Infection
  6. People born to parents from countries with a very high Prevalence of Hepatitis B Infection
  7. Chou (2014) Ann Intern Med 161(1): 31-45 [PubMed]

III. Labs: 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

IV. Labs: 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

V. Course: 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

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: Hepatitis B e Antigens (C0019167)

Definition (MSH) A closely related group of antigens found in the plasma only during the infective phase of hepatitis B or in virulent chronic hepatitis B, probably indicating active virus replication; there are three subtypes which may exist in a complex with immunoglobulins G.
Concepts Immunologic Factor (T129)
MSH D006513
SnomedCT 60605004
LNC LP38329-6, LP28795-0, MTHU004548
English Antigens, Hepatitis Be, Be Antigens, Hepatitis, HBeAg, Hepatitis B e Antigens, Hepatitis Be Antigens, Antigens, e, e Antigens, Hepatitis E antigen, Hepatitis e antigen, Hepatitis B e Antigens [Chemical/Ingredient], e antigens, hepatitis b e antigen, hbeag, Hepatitis B virus e Antigen, Hepatitis B virus little e Ag, Hepatitis B E Antigen, Hbe Ag, Hepatitis B associated e antigen, Hepatitis B e antigen, Hepatitis B e antigen (substance)
Swedish Hepatit B e-antigener
Spanish antígeno e de la hepatitis, Hbe Ag, antígeno e asociado con la hepatitis B, antígeno e de la hepatitis (sustancia), antígeno e de la hepatitis B (sustancia), antígeno e de la hepatitis B, AgeHB, Antígenos E, Antígenos e de la Hepatitis B
Czech hepatitida B - antigeny e
Finnish B-hepatitti-e-antigeenit
Russian GEPATITA B VIRUSA ANTIGENY E, GEPATITA B E-ANTIGENY, E-ANTIGENY, HBEAG, E-АНТИГЕНЫ, ГЕПАТИТА B E-АНТИГЕНЫ, ГЕПАТИТА B ВИРУСА АНТИГЕНЫ E
Japanese B型肝炎e抗原, HBe抗原, e抗原, 抗原-HBe
French Antigène HBe, Ag HBe, Antigène HBe de l'hépatite B, Antigènes e du virus de l'hépatite virale B, Antigènes e, Antigènes e de l'hépatite B, Antigènes e associés à l'hépatite B, Antigènes HBe de l'hépatite B
Polish Antygeny E, HBeAg, Antygeny HBE
German E-Antigene, HBeAg, Hepatitis-B-e-Antigene
Italian Antigeni dell'epatite B e
Portuguese Antígenos E da Hepatite B, Antígenos E, HBeAg

Ontology: Hepatitis B Surface Antigens (C0019168)

Definition (NCI) Any one of the hepatitis B antigens found on the surface of the Dane particle and on the 20 nm spherical and tubular particles. Several subspecificities of the surface antigen are known. These were formerly called the Australia antigen.
Definition (MSH) Those hepatitis B antigens found on the surface of the Dane particle and on the 20 nm spherical and tubular particles. Several subspecificities of the surface antigen are known. These were formerly called the Australia antigen.
Concepts Immunologic Factor (T129) , Pharmacologic Substance (T121)
MSH D006514
SnomedCT 22290004
LNC LP38331-2, MTHU001814
English Antigen, Australia, Australia Antigen, HBsAg, Hepatitis B Surface Antigen, Hepatitis B Surface Antigens, hepatitis B surface antigen, Hb s Ag, Hb<sub>s</sub> Ag, Hepatitis B virus surface antigen, AUSTRALIA ANTIGEN, HAA (hepatitis associated antigen), HBsAg (hepatitis B surface antigen), Hepatitis surface antigen, hepatitis b surface antigen, Hepatitis B Surface Antigens [Chemical/Ingredient], australian antigen, hb s ag, hepatitis surface antigen, hbs ag, antigen australia, australia antigen, hb ag, hbsag, Australia antigen, HbsAg, hepatitis associated antigen, Hepatitis B Virus HBsAg Surface Protein Antigen, Hepatitis B virus surface Ag, Hepatitis B virus surface Antigen, Hepatitis associated antigen, HEPATITIS B VIRUS HBSAG SURFACE PROTEIN ANTIGEN, Australian antigen, Hepatitis B surface antigen, Hb>s< Ag, Hepatitis B surface antigen (substance), HEPATITIS B SURFACE ANTIGEN
Swedish Hepatit B-ytantigener
Spanish antígeno de superficie de la hepatitis, antígeno australiano, antígeno de superficie de la hepatitis (sustancia), antígeno de superficie de la hepatitis B (sustancia), antígeno de superficie de la hepatitis B, AgsHB, Antígeno Australia, Antígenos de Superficie de la Hepatitis B
Czech HBsAg, hepatitida B - antigeny povrchové
Finnish Hepatiitti B:n pinta-antigeenit
Italian HBsAg, Antigene Australia, Antigene di superficie dell'epatite B, Antigeni di superficie dell'epatite B
Russian AVSTRALIISKII ANTIGEN, GEPATIT-ASSOTSIIROVANNYI ANTIGEN, GEPATITA B VIRUSA ANTIGENY POVERKHNOSTNYE, GEPATITA B POVERKHNOSTNYE ANTIGENY, ANTIGEN SYVOROTOCHNOGO GEPATITA, HBSAG, АВСТРАЛИЙСКИЙ АНТИГЕН, АНТИГЕН СЫВОРОТОЧНОГО ГЕПАТИТА, ГЕПАТИТА B ВИРУСА АНТИГЕНЫ ПОВЕРХНОСТНЫЕ, ГЕПАТИТА B ПОВЕРХНОСТНЫЕ АНТИГЕНЫ, ГЕПАТИТ-АССОЦИИРОВАННЫЙ АНТИГЕН
Japanese B型肝炎表面抗原, HBs抗原, HB表面抗原, SH抗原, オーストラリア抗原, 抗原-HB表面
French Antigènes s de l'hépatite B, Antigènes de surface du virus de l'hépatite B, Antigène HBs, Antigène de surface de l'hépatite B, Antigènes de surface de l'hépatite B, Antigène Australie, Antigène Australia, Antigènes HBs de l'hépatite B, Ag HBs, Antigène HBs de l'hépatite B
Croatian HEPATITIS B POVRŠINSKI ANTIGENI
Polish Antygeny zapalenia wątroby B powierzchniowe, Antygeny Australia, Antygeny HBS, HBsAg
Portuguese Antígeno Hbs, Antígeno Austrália, Antígenos de Superfície da Hepatite B, HBsAg
German Australia-Antigen, HBsAg, Hepatitis-B-Oberflächenantigene