What does the following serological result indicate: HBsAg+, anti-HBs-, anti-HBc+, HBeAg- and anti-HBe+?

Author: Prof. Peter Erb

Updated: 07 / 2012

Answer: 161-GB

This serological pattern could indicate any of the following three possibilities:

  • The patient is recovering from an HBV infection. HBeAg is barely detectable while corresponding anti-HBe antibodies are present. Later, HBsAg will decline below the detection level and finally, anti-HBs antibodies will appear.
  • There has been an HBeAg/anti-HBe seroconversion and the patient can become an inactive carrier of the virus. HBsAg remains positive but HBV DNA levels are very low (<105 copies/ml) or even undetectable. Transaminase values are stable and normal.
  • The patient has chronic hepatitis with a mutation in the pre-core and basal core promotor region. The virus replicates at a high rate, indicated by a significant level of HBV DNA and elevated transaminase values.

References:

EASL Clinical Practice Guidelines: management of chronic hepatitis B virus infection. J Hepatol 2012 (in press)