Understanding Hepatitis B Profile
Hepatitis B Profile plays an important role in detection, classification, and management of Hepatitis B infection. It involves measurement of several hepatitis B virus (HBV)-specific antigens and antibodies.
Different markers or combinations of markers are used to identify different phases of Hepatitis B Virus infection and to determine whether a patient has acute or chronic HBV infection, is immune to Hepatitis B Virus as a result of prior infection or vaccination, or is susceptible to infection.
Components of the Hepatitis B Virus
The Hepatitis B virus is the causative organism for the Hepatitis B infection. It is a DNA virus composed of the following antigenic particles:
- Hepatitis B core antigen (HBcAg) – This is an antigenic material in an inner core
- Hepatitis B surface antigen (HBsAg) – This is an antigenic material on the viral surface, a marker of active replication and infection
- Hepatitis B e-antigen (HBeAg)—an independent protein circulating in the blood
- Hepatitis B x-antigen (HBxAg) —gene product of X gene of HBV DNA
Each antigen elicits its specific antibody which becomes a marker for different stages of the disease process. The following are their respective antibodies:
- Anti-HBc / HBcAb is an antibody to HBcAg
- Anti-HBs / HBsAb is an antibody to HBsAg
- Anti-HBe / HBeAb is an antibody to HBeAg
- Anti-HBxAg is an antibody to HBxAg
The result may be presented as Positive/Reactive or Negative/Non-Reactive as shown in the picture below. Positive or Reactive indicates antibody or antigen detectable in the serum (blood) whiles negative or Non-Reactive indicates antibody or antigen is undetectable in the serum (blood).
The presence of HBsAg indicates that the person is infectious: in acute or chronic hepatitis B or carrier state. Persistence of HBsAg after 6months indicates carrier or chronic state.
Its presence indicates prior exposure and immunity to hepatitis. It may also indicate passive antibody from Hepatits B Immune Globulin (HBIG – Booster) or immune response from hepatitis B vaccine.
Its presence indicates highly infectious stage of hepatitis B. Also persistence in serum indicates progression to chronic hepatitis B infection.
Its presence usually signifies reduced infectivity
Found in liver cells and not easily detected in serum
Most sensitive indicator of hepatitis B and appears late in the acute phase of the disease. Its presence indicates infection of HBV at some time in the past.
Its presence may indicate ongoing replication of Hepatitis B Virus
Note that Hepatitis testing and treatment is not based on any single marker. It involves simultaneous interpretation of all serologic markers, HBV DNA, and liver enzymes.
Written By Assandoh-Mensah Prince
(The author is a Registered Nurse, Health Promoter and Career Development Analyst. He has been a resource person at countless number of conferences and students platforms both on career developments and health promotion/education. You can contact him via WhatsApp on +233 (0) 241626446.)
Hinkle, J. L. (2014). Brunner & Suddarth’s textbook of medical-surgical nursing (Edition 13.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., & Bucher, L. (2014). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (9th ed.). St. Louis: Elsevier
Mekaroonkamol, P. (2014). Hepatitis B Test. Retrieved 9th March, 2018 from https://emedicine.medscape.com/article/2109144-overview#showall
Osei, E., Lokpo, S. Y., & Agboli, E. (2017). Sero-prevalence of hepatitis B infection among blood donors in a secondary care hospital, Ghana (2014): a retrospective analysis. BMC Research Notes, 10, 391. http://doi.org/10.1186/s13104-017-2733-3
Sommers, M. S. (2011). Diseases and disorders: A nursing therapeutics manual. Philadelphia: F.A. Davis Co.
Williams, L.S. & Hopper, P.D. (2011). Understanding medical surgical nursing. Philadelphia, Pa. :F.A. Davis
World Health Organisation. (July 2017). Hepatitis B. Fact Sheet. Retrieved 8th March, 2018 from http://www.who.int/mediacentre/factsheets/fs204/en/