Hepatitis B e antibody (anti-HBe) positive

Introduction Hepatitis B e antibody (anti-HBe) is positive, indicating that most of the hepatitis B virus replication ceases, and the condition changes from activity to rest. Anti-HBE, also known as hepatitis B e antibody, the English abbreviation is HBeAb. It and HBeAg are a pair of corresponding antigen-antibody systems. When the E antigen was negative, the E antibody HBeAb and the surface antibody HBsAb appeared simultaneously, indicating that the hepatitis B virus replication stopped or was slow, and the liver lesions were stable. Hepatitis B surface antibody is an immune and protective antibody against hepatitis B virus. Its positive indicates that it has been infected with hepatitis B virus, but has already ruled out the virus, or has been vaccinated with hepatitis B vaccine to produce protective antibodies. The higher the titer of hepatitis B surface antibody in serum, the stronger the protective force. However, there are also a small number of people with hepatitis B surface antibody positive and hepatitis B, which may be different for different subtype infections or hepatitis B virus.

Cause

Hepatitis B surface antibody is an immune and protective antibody against hepatitis B virus. Its positive indicates that it has been infected with hepatitis B virus, but has already ruled out the virus, or has been vaccinated with hepatitis B vaccine to produce protective antibodies. The higher the titer of hepatitis B surface antibody in serum, the stronger the protective force. However, there are also a small number of people with hepatitis B surface antibody positive and hepatitis B, which may be different for different subtype infections or hepatitis B virus.

It and HBeAg are a pair of corresponding antigen-antibody systems. When the E antigen was negative, the E antibody HBeAb and the surface antibody HBsAb appeared simultaneously, indicating that the hepatitis B virus replication stopped or was slow, and the liver lesions were stable. In chronic hepatitis B, serum HBeAg is converted to anti-HBe, and the viremia level is reduced and the condition is gradually relieved. However, some patients continue to have high levels of viremia, progression of the disease, long-term ALT abnormalities, and multiple reactivations during follow-up, which is the anti-HBe (+) chronic hepatitis B discussed in this section. About 20% of anti-HBe(+) in chronic hepatitis B. Anti-HBe(+) chronic hepatitis B is a specific clinical entity, defined as disease activity, HBV DNA can be detected in serum, and IgM anti-HBc can also be positive.

an examination

Related inspection

Anti-G hepatitis E virus E2 antibody serum anti-S2 protein serum pre-S1 protein serum pre-S2 protein

Hepatitis B e antibody (anti-HBe) positive examination diagnosis:

The hepatitis B e antibody is produced when the e antigen has disappeared or is about to disappear, indicating that HBV-DNA replication is inhibited and is a seroconversion of the e antigen. Simply put, the e antigen disappears and the hepatitis B e antibody appears. Hepatitis B e antibody is positive, indicating that the replication of hepatitis B virus has been suppressed, but it is still infectious, but the infection is weak and the virus is slow to replicate. In addition, if a normal person is injected with a hepatitis B vaccine, the e antibody may also be weakly positive, but will soon disappear automatically.

Anti-HBe positive, indicating that most of the virus replication stops, and the condition will change from active to static. When HBeAg turns negative, anti-HBe turns yang, which is clinically called "serum HBeAg/anti-HBe conversion". At this time, the patient has been converted from immune tolerance to immune activation, the virus is active, replication (highly infectious) tends to replicate static (no or low infectivity), the virus is stable and the lesion is still, and HBV DNA is also negative. It has been reported that serum HBeAg is converted to anti-HBe and HBV DNA integration may be an early signal of liver cancer.

Anti-HBe positive, although no virus activity is still, but the virus did not disappear from the body. Only anti-HBe positive and HBV DNA negative, can indicate that the virus has not replicated, if anti-HBe positive and HBV DNA positive, it still indicates that the virus replicates and is highly contagious. Anti-HBe positivity also increases with age.

Differential diagnosis

HBeAG and anti-HBe are both positive:

There are two possibilities for HBeAb and anti-hbe simultaneous positive:

1. If the condition improves, it should be considered that it is currently in the stage of conversion of hepatitis B e antigen to hepatitis B e antibody. Hepatitis B e antibody appears early, and hepatitis B e antigen may tend to disappear in the near future. This should be followed up.

2. If the condition is serious, the patient's immune function should be considered low, and the cellular immune regulation is in a disordered state, indicating a poor prognosis.

The significance of hepatitis B e antigen from yang to yin:

1. Naturally negative: For those who are infected with hepatitis B virus due to horizontal transmission after adulthood, 10% to 20% of HBeAg is negative every year due to the function of immune function, but for mother-to-child transmission or infection in infants and young children, Then the HBeAg conversion rate is much lower, only 3% to 5%.

2, after the acute attack to yin: because the body's immune function is excited, immune cells attack the hepatitis B virus located in the liver cells, so that the liver cells are damaged, the virus is inhibited, at this time there may be a transient transaminase increase.

3, the application of antiviral drugs: such as interferon to make patients with HBeAg negative rate of 30% ~ 40%, lamivudine to make patients with HBeAg negative rate of 20% in the first year, the second, third, fourth year Up to 30%, 40% and 50%. Due to the low natural conversion rate of HBeAg, antiviral drugs can only make some cases negative. Therefore, HBeAg positive patients are currently treated with antiviral drugs, such as interferon + dexamerone, interferon + nucleoside drugs, nucleosides. Drugs + cytokines, two nucleoside drugs (such as lamivudine + famciclovir), interferon + oxymatrine, lamivudine + oxymatrine, etc., the key is to correctly grasp the antiviral treatment opportunity.

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