POST LAB FOR HEPATITIS B

Prepared by:

Richard Ryan R. Mergal

HBV
Antigens Antibodies

Surface Antigen Surface An

HBsAg Anti HBs

Core Antigen Core Antib

HBcAg Anti HBc

HBV 'e' Antigen HBV 'e' Ant

HBeAg Anti HBe
 The HBV Antigens
Hepatitis B Surface Antigen (HBsAg).
The first hepatitis B antigen to be discovered and occasionally referred to as the
"Australian" antigen. Found on the surface structure of the HBV virus particle.
This antigen is the first to appear in blood serum.

Hepatitis B Core Antigen (HBcAg).

The only HBV antigen that can not be detected directly by blood test. This
antigen can only be isolated by analysing an infected liver cell (Hepatocyte).
Found in the core section of the HBV virus particle.

Hepatitis B e Antigen (HBeAg).

Believed to be located in the core structure of the virus molecule this antigen is
the only other antigen which can be detected by blood test. If found it is usually
indicative of complete virus particles in circulation (i.e.. a high quality virus).
 The HBV Specific Antibodies
Hepatitis B Surface Antibody (Anti HBs)
In a normal immune reaction this antibody is the last to be found in blood. It's
presence can usually be detected sometime after HBsAg has cleared This
antibody indicates recovery from infection and there after long term protection
(Bonino, 1992).

Hepatitis B Core Antibody (Anti HBc).

Unlike it's triggering antigen, core antibody can be detected in blood serum. It is
usually the first antibody to appear occurring sometime after the levels of HBsAg
and HBeAg have peaked. It is an antibody which lasts indefinitely within blood
serum post infection and provides a useful indicator for past HBV infection.

Hepatitis B e Antibody (Anti HBe)

This antibody is normally the second to become detectable in blood serum,
appearing shortly after Anti HBc and prior to the complete disappearance of 'e'
antigen. By the time Anti HBs has appeared levels of this antibody are already
decreasing.
HEPATITIS B MARKERS
Chronic Carrier Status
Chronic Carrier Status*
 Test Result Interpretation/s Recommendation
/s

HBsAg positive the patient is a carrier. DOES NOT NEED THE HEPATITIS B VACCINE.
Anti-HBc positive

the patient has been exposed and has probably

developed natural immunity. Alternatively, he
HBsAg negative may be an individual with an isolated Anti- DOES NOT NEED THE VACCINE.
Anti-HBc positive HBc result (HBsAg negative, Anti-HBc
positive and Anti-HBs negative).

HBsAg negative
the patient is susceptible to hepatitis B. GIVE THE FULL VACCINE PROTOCOL.
Anti-HBc negative

HBsAg positive the patient is infected with hepatitis B and is

DOES NOT NEED THE HEPATITIS B VACCINE.
Anti-HBs negative probably a carrier.

HBsAg negative the patient has already been exposed and has
DOES NOT NEED THE VACCINE.
Anti-HBs positive developed natural immunity or has been
successfully vaccinated.

HBsAg negative
the patient is susceptible. SHOULD RECEIVE THE VACCINE.
Anti-HBs negative
 Key points to Note
1.Hepatitis can be categorized in to two main types, regardless of the cause.
Acute Hepatitis -Hepatitis which lasts for no longer than six months.
Chronic Hepatitis -Hepatitis which persists for longer than six months.

2.The Hepatitis B virus has three antigens in it’s structure, and can evoke the production
of three corresponding antibodies.

3.Serological blood testing can effectively map the progress of HBV infection.
4.
5.A normal immune response to the presence of the HBV causes acute hepatitis.
6.
7.Symptoms of acute HBV infection are caused through the inflammation generated
by the immune response.

•Patients with Chronic Hepatitis B Infection will normally show no symptoms of acute
disease, and therefore may carry the virus for years being unaware of it’s presence.

7.Carrier Status refers to those patients who are potentially an infection risk as they have
a maintained presence of HBV; i.e. they have chronic hepatitis.