Hepatitis Serologic Markers

  >   Rahul's Noteblog   >   Notes on Virology   >   Hepatitis Serologic Markers

Hepatitis Serologic Markers:

I've noticed a lot of people have a hard time memorizing the Hepatitis serologic markers and their association with disease status in a Hepatitis patient. In this article, I'll attempt to provide a simple way to remember and recall some basic Hepatitis serologic markers and their application in internal medicine.

First of all, I'd like you to carefully look at Figure 1 below:

Structure of a Hepatitis Virus:

Structure of Hepatitis Virus

All you have to do is memorize three letters: "S-E-C" for "surface," "envelope," and "core." Note that this may not be the correct structure of a Hepatitis virus, but may serve its purpose in helping us remember some important serologic markers.

Now, look at the diagram below:

Timeline of Hepatitis Serologic Markers:

USMLE chart of Hepatitis Serologic Markers

This diagram displays the rising and falling Hepatitis serologic markes after months of exposure. Let us start from the beginning of Hepatitis infection.

Explanation:

1. The first serologic marker that shows up in a Hepatitis infection is HBsAg. According to Figure 1, HBsAg is the "outermost" portion of the Hepatitis virus and is detected first. In indicates a carrier state. Note that this is an antigen i.e., an antibody generator. However, the HBsAb will come later during the infection.

2. The second serologic marker that shows up in a Hepatitis infection is HBeAg. According to Figure 1, HBeAg is the "middle" portion of the Hepatitis virus and is detected second. It is an indicator of active viral replication and high transmissibility. Note that this is an antigen i.e., an antibody generator. However, the HBeAb will come later during the infection.

3. According to Figure 1, the third serologic marker in a Hepatitis infection should have been "HBcAg," however, for USMLE purposes we ignore this antigen. Instead we state that the third serologic marker is the antibody to HBcAg i.e., HBcAb. However, there are two antibodies to HBcAg: IgG and IgM. IgM indicates recent disease and IgG indicates chronic disease.

4. Now we have the antibody to HBeAg called HBeAb and this is an indicator of low transmissibility. This is our body's reaction to step 2 above. Note that HBeAg increases the risk for vertical transmission to baby in pregnant women.

5. Now comes the "window period." This is the time when the body is desperately generating antibodies to HBsAg. The only serologic markers positive during the window period are HBcAb and HBeAb.

6. The antibody to HBsAg is finally being produced and is called HBsAb. This means that the body is now immune to Hepatitis B infection.

Additional Notes:

The presence of HBsAb signifies immunity; the presence of HBsAb and HBcAb signifies past infection.

Additional Readings:

Basic Virology

1. Immune defences against viruses
2. Viral Hepatitis
3. DNA viruses
4. Positive-sense RNA viruses
5. Human Immunodeficiency Virus
6. Negative sense RNA viruses
7. Double stranded RNA Viruses
8. Viruses associated with cancer
9. Generalized vs specialized transduction
10. Hepatitis serologic markers
11. Bacterial vs viral infections
12. Human Immunodeficiency Virus (HIV) Infections and AIDS
13. Steps When Patient is Newly Diagnosed with HIV

Related Topics

1. Prenatal Infections

Medical Images

Useful Medical Images & Diagrams (link opens in a new window)

Random Pages:

My Experience during the Iraqi Invasion of Kuwait Video of American Robin feeding her chicks
Video of me playing Titanic Piano Theme: The Portrait Notes on Integument
Notes on Osteology of Pectoral Region What is Folliculitis?
Notes on Nitrogen Fixation (Metabolism) reactions, and Heme Metabolism Causes and Complications of Arteriovenous Fistulas
Early Development and Disorders Notes on Digestion
Notes on Basic Gastrointestinal Physiology My Experience during the Iraqi Invasion of Kuwait
Review of the HMT Janata Hindi Dial wrist watch What is an ELEK`s Test?
Why did I decide to become a doctor? Medical School Admissions Essay Video: Titanic Piano Theme: The Portrait
Corporate Failure: The Enron Case My Experience during the Iraqi Invasion of Kuwait
USMLE Blood Lab Values Regulation of Heart Rate by Autonomic Nervous System
Images of Antibodies What is Steady State Concentration?
Notes on Muscle Tissue Differentiation and Anatomy of a Blastocyst
Notes on Cell Components Notes on Nervous Tissue
Voices from Hell: My Experience in Mussoorie, India Video of Cardiology Examination in a Clinical Setting

Please Do Not Reproduce This Page

This page is written by Rahul Gladwin. Please do not duplicate the contents of this page in whole or part, in any form, without prior written permission.