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POST LAB FOR HEPATITIS BPOST LAB FOR HEPATITIS B

Prepared by:

Richard Ryan R. Mergal

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HBVHBV

Surface Antigen Surface A

HBsAg Anti HBs

Core Antigen Core Anti

HBcAg Anti HBc

HBV 'e' Antigen HBV 'e' An

HBeAg Anti HBe

Antigens Antibodies

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The HBV AntigensThe HBV Antigens

Hepatitis B Surface Antigen (HBsAg).The first hepatitis B antigen to be discovered and occasionally referred to as the"Australian" antigen. Found on the surface structure of the HBV virus particle.This antigen is the first to appear in blood serum.Hepatitis B Core Antigen (HBcAg).

The only HBV antigen that can not be detected directly by blood test. Thisantigen can only be isolated by analysing an infected liver cell (Hepatocyte).Found in the core section of the HBV virus particle.Hepatitis B e Antigen (HBeAg).

Believed to be located in the core structure of the virus molecule this antigen isthe only other antigen which can be detected by blood test. If found it is usuallyindicative of complete virus particles in circulation (i.e.. a high quality virus).

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The HBV Specific AntibodiesThe HBV Specific AntibodiesHepatitis B Surface Antibody (Anti HBs)

In a normal immune reaction this antibody is the last to be found in blood. It's presence can usually be detected sometime after HBsAg has cleared Thisantibody indicates recovery from infection and there after long term protection(Bonino, 1992).Hepatitis B Core Antibody (Anti HBc).

Unlike it's triggering antigen, core antibody can be detected in blood serum. It isusually the first antibody to appear occurring sometime after the levels of HBsAgand HBeAg have peaked. It is an antibody which lasts indefinitely within bloodserum post infection and provides a useful indicator for past HBV infection.

Hepatitis B e Antibody (Anti HBe)This antibody is normally the second to become detectable in blood serum,appearing shortly after Anti HBc and prior to the complete disappearance of 'e'antigen. By the time Anti HBs has appeared levels of this antibody are alreadydecreasing.

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HEPATITIS B MARKERS

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Chronic Carrier StatusChronic Carrier Status

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Chronic Carrier Status*Chronic Carrier Status*

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Test Result/s

Interpretation/s Recommendation

HBsAgAnti-HBc

positivepositive

the patient is a carrier. DOES NOT NEED THE HEPATITIS B VACCINE.

HBsAgAnti-HBc

negativepositive

the patient has been exposed and has probablydeveloped natural immunity. Alternatively, hemay be an individual with an isolated Anti-HBc result (HBsAg negative, Anti-HBc

positive and Anti-HBs negative).

DOES NOT NEED THE VACCINE.

HBsAgAnti-HBc

negativenegative

the patient is susceptible to hepatitis B. GIVE THE FULL VACCINE PROTOCOL.

HBsAgAnti-HBs

positivenegative

the patient is infected with hepatitis B and isprobably a carrier.

DOES NOT NEED THE HEPATITIS B VACCINE.

HBsAgAnti-HBs

negativepositive

the patient has already been exposed and hasdeveloped natural immunity or has beensuccessfully vaccinated.

DOES NOT NEED THE VACCINE.

HBsAgAnti-HBs

negativenegative

the patient is susceptible. SHOULD RECEIVE THE VACCINE.

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Key points to NoteKey points to Note

1.Hepatitis can be categorized in to two main types, regardless of the cause.Acute Hepatitis -Hepatitis which lasts for no longer than six months.Chronic Hepatitis -Hepatitis which persists for longer than six months.

2.The Hepatitis B virus has three antigens in its structure, and can evoke the productionof three corresponding antibodies.

3.Serological blood testing can effectively map the progress of HBV infection.

4.5.A normal immune response to the presence of the HBV causes acute hepatitis.6.7.Symptoms of acute HBV infection are caused through the inflammation generated

by the immune response.

Patients with Chronic Hepatitis B Infection will normally show no symptoms of acutedisease, and therefore may carry the virus for years being unaware of its presence.

7.Carrier Status refers to those patients who are potentially an infection risk as they havea maintained presence of HBV; i.e. they have chronic hepatitis.