A person had undergone the serology for suspected hepatitis B infection. His/Her serology shows the presence of HBs antigen and also IgG anti-HBc along with the presence of anti-HBe, while HBe antigen is negative. Which one of the following diagnoses is the correct interpretation of the serology results?
Chronic hepatitis B infection with low viral replication
The profile is HBsAg positive (ongoing infection), IgG anti-HBc (infection older than 6 months) and HBeAg negative with anti-HBe positive (e-seroconversion). Persistence of HBsAg beyond 6 months defines chronic hepatitis B; HBeAg is the marker of active replication and high infectivity, so its loss with appearance of anti-HBe indicates the low-replicative inactive carrier phase.
Acute (active) hepatitis B would show IgM anti-HBc with HBsAg and usually HBeAg positivity. Chronic infection with active replication requires HBeAg positivity or high HBV DNA, which is absent here. Recovery or vaccination is excluded because HBsAg persists; recovery shows anti-HBs plus anti-HBc, while vaccination shows anti-HBs alone with anti-HBc negative.
Key point: HBsAg = infection; IgM anti-HBc = acute; IgG anti-HBc = chronic/past; HBeAg = high replication and infectivity; isolated anti-HBs = vaccinated.
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3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury
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