Interpreting
Hepatitis B Markers
Hepatitis B Markers
Pattern
Number
HBsAg HBeAg
Anti
HBc
Anti
HBe
Anti
HBs
Interpretations
I
Indicates
susceptibility
to hepatitis B infection. Patient
has never hati hepatitis B infection or is in the early
incubaton period of infection.
II
+
May indicate past resolved infection with selective loss of
anti-HBc and anti-HBeorimmunisation without infection
either passive temporary immunisation with HBIG
active long-term immunisation with hepatitis B vaccine.
Noninfectious.
III.
+
Late incubation od or very early stage of acute infection.
Infectious
IV
+
+
Early state of acute infection. Highly infectious
V
+
+
Like pattem VI, this indicates past rpsolved HBV infection
but anti-HBe not persistent or detectable. Suggests immu-
nity to subsequent infections. Noninfectious
VI
±
+
+
Indicates past resolved HBV infection:
.
suggests immu-
nity to subsequent infections. Noninfectious
VII
+
+
+
Acute or chronic infection. Highly infectious
VIII
+
+
Acute or chronic infection: stage after HBeAg has disap-
peared but anti-HBe not yet detectable. Follow-up sero-
logy indicated. Infectious
IX
+
+
+
+
Mid-to-late stage of acute infection or chronic carrier
state. Period of seroconversion from HBcAg to anti-
HBe. Follow-up serology indicated. Infectious
X +
+
+
Mid-to-late stage of acute infection or chronic carrier
state. Follow-up serology indicated.
Potentially infectious
XI
+
This most often represents remote resolved infection with
selective
,
loss of anti-HBs. This may also represent the
'window' phase of an acute infection; chronic infection
with HBsAg below the limits of detection; or an erroneous
test result. Remotely potentially infectious
XII
+
+
This may represent resolving infection with anti-HBs not
yet detectable; infection in the distant past with non-
persistent anti-HBs; or, rarely, current infection with
HBsAg below the limits of detection. Remotely poten-
tially infectious
XIII
+
A rate profile that most likely represents an erroneous test
result. Repeat serology indicated.
XIV
+
Probably erroneous test result. If anti-HBe were truly
positive, then anti-HBc and perhaps anti-HBs should also
be positive. Repeat serology indicated.
XV
+
+
+
+
A profile observed occasionally that could indicate circu-
lating immune complexes of HBsAg in similar propor-
tions so that both remain detectable; HBsAg and anti-HBs
of different subtypes; or an erroneous anti-HBs test result.
Infectious
Cermin Dunia Kedokteran No. 68, 1991 37
Typical Serologic Profile of Acute HBV Infection
If applicable, marker patterns can be plotted on the graphic dicating the points
at which they are most likely to occur.
In general for a resolving infection, HBeAg is present more transiently than
HBsAg. Anti-HBe may not be detected even in a resolved infection.
HBV = hepatitis B virus
HBsAg = hepatitis B surface antigen
HBeAg = hepatitis B antigen
Anti-HBc = antibody to hepatitis B core antigen
Anti-Hbe = antibody to hepatitis B antigen
Anti-HBs = antibody to hepatitis B surface antigen
A day is waisted when you haven't laughed
Cermin Dunia Kedokteran No. 68, 1991
38