Hepatitis B (HBe Ag)

General information:

The tests offered by Laborexpress 2000 detect current or previous infection with the Hepatitis B virus (HBV). Some of the tests report viral proteins (antigens) or antibodies produced by the patient's body in response to the infection. There are also those that take into account the genetic material (viral load) of the virus.
Hepatitis B is one of five viruses that cause inflammation of the liver. The virus is transmitted through contact with blood or other body fluids from an infected person. Exposure can occur in various cases: sexual contact, use of shared syringes, operations, dental manipulations, from mother to fetus during birth or after. The virus is not transmitted by casual contact such as shaking hands, coughing, but it lasts up to 7 days in outdoor conditions. Thus, it can be transmitted when using common toothbrushes, razor blades, arbitrary tattooing, piercing. In most cases, patients are not aware of exactly when they were infected.
Hepatitis B vaccine is administered to newborns and persons at risk of hepatitis infection (medical personnel) or visiting areas with increased morbidity. It is important to note that vaccination immunity is not 100% and must be monitored periodically (every 3-5 years) to be sure of the patient. However, it is advisable to follow precautions and avoid risk factors.
The course of the disease in different patients differs - from a mild form to a serious chronic infection that lasts for years. In certain cases, chronic carriage leads to serious complications such as cirrhosis or liver cancer.

We distinguish:

• Acute infection – presence of typical hepatitis symptoms with a positive screening test
• Chronic infection- persistent infection with established virus from laboratory tests and liver inflammation
• Carrier (inactive) infection - persistent infection, but without inflammation (a carrier is a person who appears to be in good health, but carries the virus and can potentially infect others)
• Cleared (cured) infection - no evidence of infection is found; viral antigen tests and DNA tests are negative with no symptoms of liver inflammation (although in many cases the virus is integrated into cells in an inactive state)

Reactivation – return to HBV infection with liver damage in a carrier patient or one who has been diagnosed as cured. This occurs most often in people on chemotherapy or immunosuppressants.

Although hepatitis B is a potentially serious disease, chronicity in most adult patients is relatively low. Unfortunately, chronicity in children reaches 90% in newborns and drops to 10% in school-aged children.

Symptoms: most patients with chronic hepatitis have no symptoms. In acute forms, the symptoms do not differ from other viral hepatitis: fever, fatigue, nausea, vomiting, icterus (jaundice). In acute hepatitis, the liver does not function normally. It cannot metabolize toxins and other metabolic intermediates such as bilirubin for example. Therefore, it is recommended that the diagnosis of hepatitis be accompanied by liver packs offered by the laboratory.

"e" antigen, or HBeAg, is the second antigen that appears as a result of the reproduction of the virus in the body. The presence of the "e" antigen means that the hepatitis B/HBV virus is active and multiplying in the liver cells. The presence of "e" antigen also means that the patient is contagious to others

Acute infection:

HBV surface antigen/ HBsAg,/ is detected in the blood - it can be identified within 4 weeks after infection, but it is also possible that it appears only after 9 weeks.

HBV "is" antigen, or HBeAg, is also found in the blood, which means that the virus reproduces in the liver and the person who is infected is considered highly contagious.

HBV nuclear antibody, or HBcAb (anti-HBc), is detected in the blood.
HBV surface antibody, or HBsAb (anti-HBs), is NOT detected in the blood.
Cured or cleared infection:
HBV nuclear antibody, or HBcAb (anti-HBc), is detected in the blood.
HBV surface antibody, or HbsAb (anti-HBs), is detected in the blood.
HBV surface antigen (HBsAg) is NOT detected in the blood.

Chronic infection:

HBV surface antigen, or HBsAg, is detected in the blood (for a period longer than 6 months).
HBV nuclear antibody, or HbcAb (anti-HBc), is detected in the blood.
HBV nuclear antigen, or HbcAg (HBcAg), is NOT detectable in the blood.
HBV surface antibody, or HbcAb (anti-HBs), is NOT detected in the blood.

Protected by HBV vaccination:
HBV surface antibody, or HbsAb (anti-HBs), is detected in the blood.
HBV nuclear antibody, or HbcAb (anti-HBc), is NOT detected in the blood.
HBV surface antigen, or HBsAg, is NOT detected in the blood.

HBeAg-negative hepatitis B:
HBV "e" antigen, or HBeAg, is NOT found in the blood.
HBV surface antigen, or HBsAg, is detected in the blood.
HBV nuclear antibody, or HbcAb (anti-HBc), is detected in the blood.
HBV surface antibody, or HbsAb

(anti-Hbs), is NOT detected in the blood.

Note: "e" antibodies may or may not be detected in the blood.
This can happen when there is co-infection with hepatitis B and hepatitis C.
This can also happen when surface antigen mutations are present.
People with occult HBV infection may have liver damage and should be monitored periodically and treated if liver damage occurs.

If a person has HBeAg-negative hepatitis B, it usually means that the person has been infected with hepatitis B for a long period of time, and that the virus has mutated, evolved proteins to replace and play the role of "e" antigen in the replication process. The measurement of HBV DNA, or the so-called viral load, will help determine how infectious HBV is and possibly how badly it damages the liver.

Occult hepatitis B infection:

Sometimes, a person can have HBV DNA in their blood but test negative for hepatitis B surface antigen (HBsAg) and other antigens. This is called a hidden or "occult" infection.

Chronic HBV infection is a dynamic process reflecting the interplay between HBV replication and the patient's immune response. Not all patients with chronic HBV infection have chronic hepatitis (CHB).

The natural course of chronic HBV infection has five possible course scenarios, which take into account the presence and levels of HBeAg, HBV DNA, ALT and the presence or absence of liver inflammation. The new understanding of the course of chronic hepatitis B is based on two main principles: infection or hepatitis. However, in a large number of patients, the single determination of HBV replication markers, as well as markers of disease activity, do not allow immediate classification in which phase the patient is.

Sample required:

Venous blood

Key words:

Hepatitis B, HBe Ag