Sun10October0740PM 11

A patient is referred to the infectious diseases clinic by a GP for investigation of a raised ALT of 90 IU/L. You send off a hepatitis screen and obtain the following results:

Hepatitis B surface antigen (HBsAg) positive

Hepatitis B surface antibody (anti-HBs) negative

Total hepatitis B core antibodies (anti-HBc) positive

Hepatitis B core antibodies Ig M (IgM anti-HBc) negative

Hepatitis B e antigen (HBeAg) negative

Hepatitis B e antibody (anti-HBe) positive

What do these results indicate?

(Please select 1 option)

Chronic infection/carrier Correct

Immune due to previous infection

Susceptible to hepatitis B infection

Acute infection

Immune due to previous vaccination

Explanation

The presence of hepatitis B e antigen (HBeAg) is an indicator of infectivity - its presence indicates high infectivity.

Hepatitis B surface antigen (HBsAg) is a protein on the outside of the virus and can be detected in the serum during either acute or chronic infection. It is absent in those who have been vaccinated against hepatitis B. The body normally produces antibodies to HBsAg as part of the normal immune response to infection.

Hepatitis B surface antibody (anti-HBs) is present in those who have been vaccinated. It is present in those who have mounted a successful immune response to the virus and interpreted as indicating recovery and immunity.

Total hepatitis B core antibody (anti-HBc) appears at the onset of symptoms and persists for life. Its presence indicates ongoing or previous infection with hepatitis B.

IgM hepatitis B core antibody (IgM anti-HBc) indicates acute infection. It persists for around six months after infection.

Reference:

Centers for Disease Control and Prevention (CDC). Interpretation of Hepatitis B Serologic Test Results.

World Health Organization (WHO). HBV serological markers in hepatitis patients.

Answer Statistics

1

53%

2

17%

3

2%

4

24%

5

6%

Times answered: 282