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

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).

HBsAg

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.

HBsAb

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.

HBeAg

Its presence indicates highly infectious stage of hepatitis B. Also persistence in serum indicates progression to chronic hepatitis B infection.

HBeAb

Its presence usually signifies reduced infectivity

HBcAg

Found in liver cells and not easily detected in serum

Anti-HBc

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.

Anti-HBxAg

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.)

REFERENCE

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/

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