{"id":26731,"date":"2015-04-29T04:24:30","date_gmt":"2015-04-29T04:24:30","guid":{"rendered":"http:\/\/www.homeobook.com\/?p=26731"},"modified":"2022-01-06T00:45:27","modified_gmt":"2022-01-06T00:45:27","slug":"hepatitis-b-relevance-of-serological-markers","status":"publish","type":"post","link":"https:\/\/www.homeobook.com\/hepatitis-b-relevance-of-serological-markers\/","title":{"rendered":"Hepatitis B-Relevance of Serological markers"},"content":{"rendered":"

\"hep.b\"<\/a>Dr.G.Siva Prasad<\/p>\n

ABSTRACT:<\/strong> The purpose of this article is to provide the information regarding markers of Hepatitis B virus infection and their importance in Diagnosis, Treatment and assessment of Prognosis in Hepatitis B cases.<\/p>\n

INTRODUCTION: <\/strong>\u00a0There are many parameters like HBsAg, Anti HBs, HBeAg, Anti HBe, Anti-HBc and HBV DNA are present in relation with Hepatitis B infection, which creates confusion in patients as well as physicians. And have many doubts like, \u2018is HBsAg positive became HBsAg negative?. This article gives proper information regarding the importance of serological markers in Hepatitis B cases and clears these confusions. The WHO has estimated that over 350 million people worldwide are chronically infected with HBV, high prevalence regions include most of Asia.<\/p>\n

Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV), a double stranded DNA virus which replicates by reverse transcription(Hepadnaviridae family).<\/p>\n

HBV MARKERS:\u00a0<\/strong>The parameters used to define and characterise HBV infection include:\u00a0\u00a0 1.Serological markers \u2013 HBV Antigens and host antibodies.<\/p>\n

    \n
  1. Virological markers \u2013 HBV DNA and genotype.<\/li>\n
  2. Biochemical markers \u2013 Aminotransferases.<\/li>\n
  3. Histological markers – Liver biopsy.<\/li>\n<\/ol>\n

    Hepatitis B is a complex disease, which can be defined using above parameters and Management decisions are based on an interpretation of these parameters.<\/p>\n

    SEROLIGICAL MARKERS:
    \n<\/strong>1.HBsAg: <\/strong>Hepatitis B surface antigen (HBsAg. Australian antigen) is an antigen on the three proteins that make up the envelope of the HBV virion. In acute infection,<\/strong> HBsAg characteristically appears during the incubation period, usually 1 to 6 weeks before clinical or biochemical illness develops, and disappears during convalescence, <\/strong>when the corresponding antibody (Anti HBs) appears (so in acute HBV infection cases HBsAg positive may become HBsAg negative). This anti HBs usually persists for life; its detection therefore implies hepatitis B infection in the past and relative protection against future infection.<\/p>\n

    In up to 10 % of cases HBsAg persists following acute infection and anti-HBs does not develop. These patients can develop chronic hepatitis<\/strong> or become asymptomatic carriers<\/strong> of the virus. So chronic HBV infection is defined by the persistence of HBsAg for more than six months.<\/p>\n

    2.Anti-HBs (Antibody to surface antigen): <\/strong>This is the protective antibody that develops with the resolution of acute infection or following the successful vaccination against HBV.<\/p>\n

    3.Antibody to Core antigen (anti-HBc): \u00a0<\/strong>The HBV core antigen is not found as a discrete protein in the serum. It is produced in the hepatocyte cytosol during HBV replication, surrounding the viral genome and the associated polymerse. It is then packaged within an envelope before secretion from the hepatocyte. The antibody to HBV core (anti-HBc) is an antibody to a peptide of this core protein, which has been processed with in an antigen presenting cell. In acute infection,<\/strong> anti-HBc IgM<\/strong> is found in high concentrations which gradually decline, complementing the corresponding increase in anti-HBc IgG<\/strong> over a three to six month period. Elevation of anti-HBc IgM usually signifies acute infection, but low elevations <\/strong>may also occur during the reactivation of chronic HBV. Anti-HBc IgG remains positive for life following exposure to HBV, however, unlike anti-HBs, anti-HBc is not a protective antibody.<\/p>\n

    4.HBeAg: <\/strong>It is an accessory protein from the precore region of the HBV genome. It is produced during active viral replication and may act as an immunogen or a tolerogen leading to persistent infection.<\/p>\n

    5.Antibody to e antigen (Anti-HBeAg):\u00a0 <\/strong>while anti-HBe is not a protective antibody, its appearance usually coincides with a significant immune change associated with lower HBV DNA replication. The loss of HBeAg and the development anti-HBe is termed HBeAg seroconversion<\/strong>, and has been used as an end point for treatment in HBeAg positive people, as it has been shown that seroconversion is associated with a lower risk of disease progression.<\/p>\n

    KEY POINTS \u2013SEROLOGICAL MARKERS:<\/strong><\/p>\n