Hepatitis B e antigen (HBeAg) positive

Introduction Hepatitis B e antigen is a direct indication of hepatitis B virus infection, and its persistent positive indicates that the virus has active replication, which may indicate chronic disease, which may lead to chronic hepatitis and cirrhosis. Hepatitis B E antigen, abbreviated as HBeAg, is a soluble protein in the core particles of hepatitis B virus. Under normal circumstances, HBeAg is buried inside HBcAg. When HBcAg is lysed, HBeAg dissolves into the serum from the nucleus of hepatocytes. It appears later than HBsAg, but disappears earlier than HBsAg, so it is the first to follow HBsAg after HBV infection. 2 serological antigen markers. HBeAg is transiently elevated in acute hepatitis, occurs in the incubation period before ALT rises, and then rapidly declines as the condition improves, and finally disappears. The detection rate of HBeAg in the active phase of hepatitis B is high, indicating that the liver cells have serious damage and the patient is highly contagious.

Cause

Hepatitis B virus-positive, hepatitis B virus DNA is still positive, revealing that hepatitis B virus replication is still active, may be the result of mutation of hepatitis B virus, the condition may be heavier and faster development, should pay attention. Hepatitis B virus-positive hepatitis B virus carriers are the most complicated group of patients. The hepatitis B virus DNA test can divide this group of patients into two categories: one is no hepatitis B virus replication, no infection; the other is It is a hepatitis B virus replication, accompanied by active liver disease, HBV DNA positive, infectious. Hepatitis B e antibodies can be detected in the blood of 30%-50% long-term chronic hepatitis B virus carriers.

an examination

Related inspection

Serum anti-S2 protein serum pre-S1 protein serum pre-S2 protein

Hepatitis B e antigen (HBeAg) positive examination diagnosis:

The pathogen serological examination can be diagnosed.

Enzyme-linked immunosorbent assay (ELISA): negative, P/N <2.1 Radioimmunoassay (RIA): negative.

(1) Increased HBeAg indicates that hepatitis B is highly contagious, and its appearance is often early or active in hepatitis B.

(2) If the HBeAg positive duration is greater than 10 weeks or longer, the patient may progress to a chronic persistent infection, and the liver tissue often has more serious damage. Acute hepatitis B easily evolves into chronic hepatitis or cirrhosis.

(3) HBeAg-positive pregnant women are vertically contagious, and more than 9% of newborns will be infected with hepatitis B virus, and HBeAg is also positive.

(4) HBeAg induces the immune tolerance of T cells to infection by infecting the placenta of the mother. It is the hepatitis B virus that evades the elimination of the human immune system and causes the hepatitis B virus to continue to be infected.

Differential diagnosis

Hepatitis B surface antigen (HBsAg) positive: Hepatitis B virus surface antigen (HBsAg) is an outer membrane protein of hepatitis B virus (HBV) that can appear early after infection with HBV. Hepatitis B surface antigen (HBsAg) is a coat protein of hepatitis B virus, which is not infectious in itself, but its appearance is often accompanied by the presence of hepatitis B virus, so it is a marker of hepatitis B virus infection. It can be present in the patient's blood, saliva, milk, sweat, tears, nasopharyngeal secretions, semen and vaginal secretions. Two to six months after infection with hepatitis B virus, a positive result can be detected in serum 2 to 8 weeks before alanine aminotransferase is elevated. Most patients with acute hepatitis B can turn negative in the early stage of the disease, and this indicator can be positive for patients with chronic hepatitis B.

Hepatitis B surface antibody (anti-HBs) positive: at least three problems: (1) Hepatitis B patients have reached the recovery period, and will soon say goodbye to hepatitis B virus infection; (2) He has been infected with hepatitis B virus, may have hepatitis B disease, or may not know Unexplained recessive infection, but now the virus has been cleared, obtained immunity to hepatitis B, even if hepatitis B virus invades the body, it is still safe; (3) simple anti-HBs-term positive, is injected with hepatitis B vaccine and immune The standard of success, of course, will not be infected with hepatitis B virus.

Core antibody (anti-HBc) positive: After human hepatitis B virus, hepatitis B virus nucleic acid (HBV-DNA) first appears in the serum, and hepatitis B virus surface antigen (HBsAg) and e antigen appear after about 1 month. H BeAg), then anti-HBc appeared. As the condition gradually improved, HBV-DNA, HBsAg and HBeAg in the serum were negative, and hepatitis B surface antibodies (anti-HBs) appeared after a period of disappearance of HBsAg. At this time, anti-HBc and anti-HBs can be positive at the same time. Since anti-HBs persist in serum for a shorter period of time than anti-HBc, anti-HBs disappear after a period of time, and only a single anti-HBc is positive. Whether it is a clinically symptomatic hepatitis B patient or a latent infection with no clinical manifestations, after recovery, serological tests can be expressed as a single anti-HBc positive.

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