Hepatits B Lab Interpretations

Before going through the scenarios I would like to explain a little bit about serology. When virus enter the human body a certain immune response is elicited and due to that viral antigen, body starts making antibodies.

HBsAg is Hepatitis B Surface Antigen and shows that the person is Hep B +ive while if more than 6 months has been passed then patient has gone to chronic carrier state.

HBsAb is Hepatitis B Surface Antibody and are made in response to surface antigen.

HBcAg is Hepatitis B Core Antigen.

HBcAb is Hepatitis B Core Antibody and it remains +ive throughout life after the infection even if it has be resolved.

HBeAg is Hepatitis B e Antigen and it shows active replication of virus.

Hepatitis

Scenario 1

Following are the results of some of components of hepatitis-B serology of 25 years old student.

On 1st December 2012 ...

HBsAg - Positive
HBcAb - Positive
HBeAg - Negative

On 7th June 2013 ...

HBsAg - Positive
HBcAb - Positive
HBeAg - Negative


Now these investigations show the patient is suffering from Hep B and in chronic carrier state with high transmission rate.

Scenario - 2

After listening to a lecture on hepatitis B, a medical student who had jaundice about 8 months back for which no lab investigations were carried out wants to know whether or not he had Hep B eight months back. He is found to be HBsAg Negative.

Now, THINK AND ANSWER ...

At this moment which single test is the most appropriate to rule out a previous attack of Hep B.

Is it ...

HBeAg
or
HBeAb
or
HBcAb
or
HBsAb ... ???

Scenario 3

A young lady suffered from Hepatitis B in Jan 2013. Now in June 2013 her Hepatitis B profile is as under ...

HBsAg ... Negative
HBsAb ... Positive
HBcAb ... Positive
HBeAg ... Negative
HBeAb ... Negative

Now look at investigations. Surface antibodies are positive while Antigen is negative so it is clear that person isn't suffering from infection. Now if we see that Core Antibodies are positive that means person had infection previously. While "e" Antigens are Negative that means there is no active replication of virus in patient.

So, this is a typical scenario of a patient who has recovered from Hepatitis B virus.

Scenario 4

A young man was found to be suffering from Hepatitis B and was HBsAg Positive in December 2012. Now in June 2013 his Hepatitis B profile is as under;

HBsAg Negative
HBsAb Negative
HBcAb Positive
HBeAg & Ab Both Negative

You can see in investigations that everything is Negative EXCEPT the Hepatitis B Core Antibodies. Surface Antigen has gone negative after treatment while still Surface Antibodies are not detectable. The period before emergence of Surface Antibodies is called WINDOW PERIOD.

Scenario 5 

A medical student has appeared for blood donantion. He has no history of jaundice but he does not remember whether or not he has been vaccinated against Hepatitis B. His Hepatitis B profile is as under;

HBsAg ... Negative
HBsAb ... Positive
HBcAb ... Negative
HBeAg ... Negative
HBeAb ... Negative

If a person has been vaccinated then you will find ONLY SURFACE ANTIBODIES.

What if the same patient had Core Antibodies are POSITIVE ... ???

Scenario 6

A medical student while drawing blood from Hepatitis B patient gets accidental needle prick injury. He has not been previously vaccinated against HBV.

In this case;

He should be vaccinated and get gamma globulin on separate arms as soon as possible.

So, how was it? ... I hope you would have understood SOMEEEEETHINGGGGGG ... :D

Don't forget to give feedback and +1.