Hepatitis B: Etiology, Symptoms, Diagnosis, and Prevention Explained

Question. Describe hepatitis-B under following headings.

Answer.

Diagnosis

Serology Hepatitis-B

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HBV consists of number of antigens. The three important antigens are hepatitis B surface antigen (HBsAg), core antigen (HBeAg) and hepatitis e antigen (HBeAg).
Appearance of hepatitis B surface antigen (HBsAg) in serum is the fist evidence of infection.
It normally persists for 3–4 weeks, but can persist up to 6 months.
After disappearance of HBsAg, antibody against HBsAg (antiHBs) appears and persists for years and confers immunity.
Presence of antiHBs antibody means either previous infection or vaccination.
HBeAg is not seen in the blood.
However, antibody to it (antiHBc) appears early during the illness.
Presence of IgM antiHBc indicates acute infection and IgG antiHBc suggests chronic infection (when HBsAg positive) or recovery (when antiHBs positive).
Presence of HBeAg indicates active viral replication and high degree of infectivity.
AntiHBe appears as HBeAg disappears and its presence suggests low level of viral replication and decreased infectivity.
Above mentioned serological tests are done to identify the cause of hepatitis.

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Viral Blood Hepatitis-B

HBV DNA is measured by polymerase chain reaction in blood.
Viral loads are in excess of 105 copies/mL in presence of active viral replication.

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Other Investigations Hepatitis-B

During early phase of hepatitis there is an increase in more than 400 units/L increase in plasma Alaline aminotransferase and aspartate aminotransferase.
High levels of alkaline phosphatase are suggestive of cholestasis.
Prothrombin time is increased which indicates severe liver damage

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