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Which additional tests do I require to be diagnosed with hep b? Last year i got HBsAG positive, DNA HBV negative results. Which other markers of HBV tests should I be tested for to know whether I am a carrier and can infect others?

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Dr. John Fung
Surgery

In brief: There

There are a number of hepatitis b virus (hbv) markers that are used to determine whether one is actively infected, latently infected, immune, or vaccinated.
Some are tests to detect antibody, for example, antibody to hbv surface antigen (sometime referred to as hbsab), antibody to the hbv core antigen (referred to as hbcab) [and a subset of the core antigen is the "e" antigen, so antibody to that is referred to as the hbeab]. Some tests detect part of the hbv itself, so the surface antigen is referred to as hbsag, the core antigen - hbcag, the e antigen - hbeag, or the dna itself or hbv dna. Hbsag can be detected in the blood from several weeks before onset of symptoms to months after onset. Hbsag is present in serum during acute infections and persists in chronic infections. The presence of hbsag indicates that the person is potentially infectious, regardless of the hbv dna level. Hepatitis b virus, hbv dna, hbcag and hbeag are also evidence of ongoing infection. The presence of hbeag is associated with relatively high infectivity and severity of disease. Anti-hbc is the first antibody to appear. Demonstration of anti-hbc in serum indicates hbv infection, current or past. Igm anti-hbc is present in high titre during acute infection and usually disappears within 6 months. Igg anti-hbc generally remains detectable for a lifetime. Anti-hbe appears after anti-hbc and its presence correlates to a decreased infectivity. Anti-hbe replaces hbeag in the resolution of the disease. Nowadays, hbv dna has often been used to replace testing for hbeag. Anti-hbs replaces hbsag as the acute hbv infection is resolving. Anti-hbs generally persists for a lifetime in over 80% of patients and indicates immunity. It is the only antibody which appears in normal patients who are vaccinated with the hbv vaccine. The presence of other antibodies suggest that the immunity was acquired thru a prior active infection rather than vaccination.

In brief: There

There are a number of hepatitis b virus (hbv) markers that are used to determine whether one is actively infected, latently infected, immune, or vaccinated.
Some are tests to detect antibody, for example, antibody to hbv surface antigen (sometime referred to as hbsab), antibody to the hbv core antigen (referred to as hbcab) [and a subset of the core antigen is the "e" antigen, so antibody to that is referred to as the hbeab]. Some tests detect part of the hbv itself, so the surface antigen is referred to as hbsag, the core antigen - hbcag, the e antigen - hbeag, or the dna itself or hbv dna. Hbsag can be detected in the blood from several weeks before onset of symptoms to months after onset. Hbsag is present in serum during acute infections and persists in chronic infections. The presence of hbsag indicates that the person is potentially infectious, regardless of the hbv dna level. Hepatitis b virus, hbv dna, hbcag and hbeag are also evidence of ongoing infection. The presence of hbeag is associated with relatively high infectivity and severity of disease. Anti-hbc is the first antibody to appear. Demonstration of anti-hbc in serum indicates hbv infection, current or past. Igm anti-hbc is present in high titre during acute infection and usually disappears within 6 months. Igg anti-hbc generally remains detectable for a lifetime. Anti-hbe appears after anti-hbc and its presence correlates to a decreased infectivity. Anti-hbe replaces hbeag in the resolution of the disease. Nowadays, hbv dna has often been used to replace testing for hbeag. Anti-hbs replaces hbsag as the acute hbv infection is resolving. Anti-hbs generally persists for a lifetime in over 80% of patients and indicates immunity. It is the only antibody which appears in normal patients who are vaccinated with the hbv vaccine. The presence of other antibodies suggest that the immunity was acquired thru a prior active infection rather than vaccination.
Dr. John Fung
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