Serological Diagnosis of Hepatitis B virus Infection

HBsAg and hepatitis B e antigen (HBeAg) are the first markers identified in the serum of patients acutely infected with HBV.

Detection of Antigen:

1.       HBsAg (also called Australia antigen or hepatitis-associated antigen):

Timeline for Acute Hepatitis B Virus Infection

HBsAg generally appears before symptom onset and peaks during overt disease. In patients who successfully clear the HBV infection and do not progress to the chronic carrier stage, HBsAg typically is undetectable 4 to 6 months after infection

2.       HBeAg:
HBeAg, a soluble protein which is contained in the core of Hepatitis B Virus. HBeAg is generally considered to be a marker of HBV replication and infectivity.

Detection of Antibody

1.       IgM anti-HBc (IgM class antibody to HBcAg)
The first antibody to appear is IgM antibody to hepatitis B core antigen (IgM anti-HBc). The presence of the IgM anti-HBc antibody is diagnostic of acute HBV infection. IgM anti-HBc is first detectable in the serum shortly before the onset of symptoms at a time generally concurrent with the onset of elevated transaminase levels.

2.       IgG anti-HBc (IgG class antibody to HBcAg)
The presence of IgG anti-HBc indicates that the patient has a history of infection with HBV. Within several weeks, the IgM anti-HBc disappears, and IgG anti-HBc is detected. IgG anti-HBc may remain present for life.

Timeline for Chronic Hepatitis B Virus Infection