Hepatitis B two and a half are currently the most commonly used serum markers for detection of hepatitis B virus in domestic hospitals. The two and a half inspection items include: Hepatitis B surface antigen, Hepatitis B surface antibody, Hepatitis B e antigen, Hepatitis B e antibody, Hepatitis B core antibody.
Hepatitis B two to half comparison table
Hepatitis B two to half is currently the most commonly used hepatitis B virus test in domestic hospitals
Hepatitis B two and a half are the most commonly used serum markers for detecting hepatitis B virus (HBV) infection in domestic hospitals.
Clinical significance
As shown
Analysis of the clinical significance of two pairs of HBV: 9 common patterns
Serial number
HBsAg
HBsAb
HBeAg
HBeAb
HBcAb
Analysis of two and a half common results of hepatitis B
Commonly known
01
-
-
-
-
-
Have not been infected with HBV in the past and present.
Preface to the two-and-a-half comparison table for hepatitis B
Hepatitis B "two and a half" is currently the most commonly used serum marker for detecting hepatitis B virus (HBV) infection in domestic hospitals, including five indicators, namely hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B e antigen (HBeAg ), Hepatitis B e antibody (anti-HBe) and hepatitis B core antibody (anti-HBc).
HBsAg HBsAg
HBsAg, also known as hepatitis-associated antigen (HAA), appears 2 to 8 weeks before the patient's serum ALT increases, and the HBsAg titer gradually decreases or even disappears during the recovery period. Anti-HBs appears, but some patients' HBsAg persists. Even if HBV has been eliminated from the human body, liver cells can continue to replicate HBsAg. After HBV infection, most people have no clinical manifestations and are called HBsAg carriers. A small number of people can develop acute or chronic hepatitis B, or even cirrhosis and liver cancer.
HBsAg can be found in the peripheral blood of most people with HBV infection, the content of which is between 5ng to 600g / ml, and the highest can reach more than 2000g / ml. However, a small number of patients with HBV infection were negative for HBsAg, such as fulminant hepatitis B and mutations in the S gene of HBV. Acute severe hepatitis has little or no HB-sAg synthesis, leaving no HBsAg in peripheral blood. Natural infection of HBV or antibodies produced by injection of HBsAg vaccine has no effect on mutant strains, and can cause simultaneous occurrence of HBsAg and anti-HBs in the serum of patients. At the same time, hepatitis B vaccination cannot prevent the infection of such mutant viruses.
Serum HBsAg is only a sign of HBV infection and does not reflect the presence or absence of virus replication, the degree of replication, the degree of infectivity, and the prognosis.
HBs Anti-HBs
After the recovery period of acute hepatitis B patients, with the gradual disappearance of HBsAg, anti-HBs appears in the serum, which has protective immune effect on HBV infection. 10mlu / m1 anti-HBs is the critical level of immunity. Below this value, it indicates that the immunity has failed. For those who receive hepatitis B vaccination, any marker other than anti-HBs in the blood should be regarded as a previous HBV infection.
In general, anti-HBs and HBsAg do not exist in the serum at the same time. If detected at the same time, it may be early in the production of anti-HBs, or belong to different subtypes of HBV infection, or caused by HBV S gene mutation.
HBeAg Hepatitis B two and a half comparison table HBeAg
HBeAg is the soluble component of HBcAg. The two have about 75% of the amino acid sequence in common. It appears later in sera than HBsAg. Generally, those who are HBeAg-positive are also positive. HBeAg-positive means that it is highly contagious. If it is positive for more than 3 months, it will be chronic. Sometimes HBsAg (-), anti-HBs (+), HBeAg (+) patterns can be seen in clinical laboratories, and it is very likely that mutations occur in the gene region encoding HBsAg of the virus.
HBe Anti-HBe
When the serum HBeAg is negative, anti-HBe may appear, and both of them are positive. Anti-HBe positive indicates reduced virus replication and weak infectivity, but not not infectious. Anti-HBe is not a protective antibody, which is different from anti-HBs.
Important indicators of hepatitis B two-and-a-half comparison table
Total anti-HBc and anti-HBcIgM
HBcAg is the most immunogenic, and then anti-HBc occurs. Total anti-HBc includes anti-HBcIgM, IgA, IgG and IgE. Anti-HBcIgM shows a high titer in the acute phase of hepatitis, which is an important indicator for judging acute hepatitis B. With the recovery of acute hepatitis B, the anti-HBcIgM titer (and anti-HBcIgA) decreases or even disappears. If the continuous high titer is chronic, it often indicates chronic tendency. In patients with chronic active hepatitis B, the detection rate and titer of anti-HBcIgM are also high, indicating that HBV replication is active and is one of the indicators of strong infectivity.
Anti-HBc is not a protective antibody. Anti-HBc showed low titer in blood and coexisted with anti-HBs, which is a sign of previous infection.
