Hepatitis B envelope Antigen and Hepatitis B envelope Antibody, Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Hepatitis B envelope antigen (HBeAg) is found in the early phase of hepatitis B infection soon after hepatitis B surface antigen becomes detectable. Serum levels of both antigens rise rapidly during the period of viral replication. The presence of HBeAg correlates with hepatitis B virus (HBV) infectivity, the number of viral Dane particles, the presence of core antigen in the nucleus of the hepatocyte, and presence of viral DNA polymerase in serum.
During recovery from acute hepatitis B, after HBeAg level declines and becomes undetectable, HBe antibody (anti-HBe) appears in the serum. Anti-HBe usually remains detectable for several years after recovery from acute infection.
In HBV carriers and chronic hepatitis B patients, positive HBeAg results usually indicate presence of active HBV replication and high infectivity. A negative HBeAg result indicates very minimal or lack of HBV replication. Positive anti-HBe results usually indicate inactivity of the virus and low infectivity. Positive anti-HBe results in the presence of detectable HBV DNA in serum indicate active viral replication in these patients.
Determining infectivity of hepatitis B virus (HBV) carriers
Monitoring infection status of chronically HBV-infected patients
Monitoring serologic response of chronically HBV-infected patients receiving antiviral therapy
Presence of hepatitis B envelope (HBe) antigen and absence of HBe antibody usually indicate active hepatitis B virus (HBV) replication and high infectivity.
Absence of HBe antigen with appearance of HBe antibody is consistent with loss of HBV infectivity.
Although resolution of chronic HBV infection generally follows appearance of HBe antibody, the HBV carrier state may persist.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
For 24 hours before blood collection, patient should not take multivitamins or dietary supplements containing biotin (vitamin B7) that is commonly found in hair, skin, and nail supplements and multivitamins.
Disappearance of hepatitis B envelope (HBe) antigen or appearance of HBe antibody in serum does not completely rule out chronic hepatitis B carrier state or infectivity.
Consider administration of hepatitis B immune globulin and hepatitis B vaccine to individuals who have been exposed to patient's blood or body fluids.
Performance characteristics of these 2 assays have not been established in patients under the age of 2 or in populations of immunocompromised or immunosuppressed patients. These 2 assays are not licensed by FDA for testing cord blood samples or screening donors of blood, plasma, human cell, or tissue products.
Performance characteristics have not been established for the following specimen characteristics:
-Grossly icteric (total bilirubin level of >20 mg/dL)
-Grossly lipemic (triolein level of >3,000 mg/dL)
-Grossly hemolyzed (hemoglobin level of >61 mg/dL)
-Specimen containing particulate matter
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
HEPATITIS BE ANTIGEN
HEPATITIS BE ANTIBODY
See Viral Hepatitis Serologic Profiles in Special Instructions.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Bonino F, Piratvisuth T, Brunetto MR, et al: Diagnostic markers of chronic hepatitis B infection and disease. Antiviral Therapy 2010;15(3):35-44
2. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis 2004;8:267-281
3. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol 2001 Jun;21(3):229-237