Patients often ask me these questions. I think it is necessary to give you some popular science in this area.
The second of the five hepatitis B items, which is the hepatitis B surface antibody, is a protective antibody. We usually say vaccination is to have this antibody, and this antibody positive will have a protective effect on our body.
But some people will say, I have not been vaccinated, how can I be 245 positive?
It turns out that adults have relatively healthy immune functions, so once they come into contact with hepatitis B virus, they will recognize the virus, clear the virus from the body, and produce such protective antibodies. Many people show this kind of 245 positive. Over time, the fourth item will slowly disappear, which is 25 positive. This is what we call the hepatitis B recovery period.
In addition, there is also a case where the hepatitis B vaccine has been injected, and then there are protective antibodies. When exposed to the virus at this time, the virus will also be cleared from the body, and a positive 245 will also appear. Happening.
Of course, in clinical work, the situation is far more complicated than these, and some patients will show 245 positive due to the mutation of hepatitis B virus surface antigen. A small amount of virus replication was detected.
So how to judge whether it belongs to the recovery period of hepatitis B or the mutation of hepatitis B virus?
It’s what we said to check for high-sensitivity HBVDNA. If there is no problem, we can check it regularly.
It should be added that if you have ever been infected with hepatitis B, even in the recovery period, the second antibody is positive. Over time, the body’s immunity changes, such as anti-tumor, hormone applications, etc., will also lead to the resurgence of the virus. Therefore, even if you recover, don’t take it lightly, but pay attention to regular review.
What are the five items of hepatitis B, and what are their clinical significance?
1. Hepatitis B Surface Antigen (HBsAg)
HBsAg is a serological marker of HBV infection. HBsAg appears in serum 1-10 weeks after acute exposure to HBV, prior to the onset of hepatitis symptoms or elevation of serum ALT. In patients who subsequently recover, HBsAg is usually undetectable after 4-6 months, and the presence of HBsAg for more than 6 months indicates chronic infection.
2. Hepatitis B surface antibody (HBsAb)
Anti-HBs appear after HBsAg disappears. In most patients, anti-HBs persist for life, thereby providing long-term immunity.
The coexistence of HBsAg and anti-HBs has been reported in 5%-30% of HBsAg-positive individuals. This is related to variations in surface antigens, and in most cases, antibodies cannot neutralize virions in the blood. Therefore, these individuals should be considered carriers of HBV.
3. Hepatitis B e Antigen (HBeAg)
is a secreted protein processed by precore protein, which is generally considered to be a marker of HBV replication and infectivity.
The presence of HBeAg is generally associated with two conditions: high levels of HBV DNA in serum; higher rates of transmission from HBV-infected mothers to their infants; and transmission from HBV-infected patients to health care The rate of transmission among people is high.
4. Hepatitis B e antibody (HBeAb)
The e-antibody was found during the examination, which means that the hepatitis B is relatively improved, which brings good news to the patient. Seroconversion of HBeAg to anti-HBe is often associated with a reduction in serum HBV DNA and remission of liver disease.
However, some patients who continue to have active liver disease after HBeAg seroconversion may have low levels of wild-type HBV or have stop codons in the pre-core region or core promoter regions with HBV variants with double nucleotide substitutions.
5. Hepatitis B core antibody (HBcAb)
A sign that appears for anyone who has been infected or is currently infected. It has certain significance for auxiliary two-half inspection.
Anti-HBc can occur in the following three situations:
The window period of acute hepatitis B, when anti-HBc is mainly IgM type;
Years after recovery from acute hepatitis B, by which time anti-HBs have fallen to undetectable levels;
Many years after chronic HBV infection, HBsAg titers have fallen below the detection threshold level.