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Hepatitis Serology Markers

Five forms of viral hepatitis
Hepatitis

A

B

C

D

E
Virus

HAV

HBV

HCV

HDV

HEV
Family Picornavirus Hepadnavirus Flavivirus Satellite Calicivirus
Genome ssRNA dsDNA ssRNA ssRNA ssRNA
Spread Fecal-oral parenteral, sexual,perinatal parenteral, ?sexual parenteral, ?sexual Fecal-oral
Antigens HAV-Ag HbsAg,HBcAg,HBeAg HCV-Ag HDV-Ag HEV-Ag
Antibodies Anti_HAV Anti-HBs,Anti-HBc,Anti-HBe Anti-HCV Anti-HDV Anti-HEV
Virus markers HAV RNA HBV DNA, DNA polymerase HCV RNa HDV RNa viruslike partiacles

Semin.Liver Ds. 11:74,1991, Thieme Medical Publishers, Inc

Hepatitis A Serology

  1. anti-HAV (antibody to hepatitis A virus)
    it detects total antibody of both IgG and IgM sublasses of HAV.  Its presence indicates either acute or resolved infection.
  2. IgM anti-HAV (IgM antibody subclass of anti-HAV, hepatitis A virus)
    it indicates a recent infection with HAV (< 6months).  It is used to diagnose acute hepatitis A

Hepatitis B Serology

  1. HBsAg (Hepatitis B surface antigen)
    it indicates either acute or chronic Hepatitis B virus (HBV) infection.
  2. anti-HBs (HBsAb = antibody to hepatitis B surface antigen)
    it is a marker of hepatitis B immunitiy.
  3. anti-HBc (HBcAb = antibody to hepatitis B core antigen)
    it is a nonspecific marker of acute, chronic, or resolved HBV infection. It is not a marker of faccine-induced immunity.
  4. IgM anti-HBc (IgM antibody sublass of anti-HBc)
    it indicates recent infection with HBV (<6 months).  Its presence indicates acute infection.
  5. HBeAg (Hepatitis B "e" antigen)
    it is a marker of a high degree of HBV infectivity, & acorrelates with a high level of HBV replicaiton.  It is primarily used to help determine the clinical management of patients with chronic HBV infection.
  6. anti-HBe (antibody to hepatitis B "e" antigen)
    it may be presnet in an infected or immune person.  In persons with chronic HBV infection, its presence suggests a low viral titer and a low degree of infectivity.
  7. HBV-DNA (HBV deoxyribonucleic acid)
    it is a marker of viral replication.  It correlates well with infectivity.  It is used to assess and monitor the treatment of patients with chronic HBV infection.

Hepatitis C Serology

  1. anti-HCV (antibodies to HCV - hepatitis C Virus) by ELISA or RIBA-2 assay
    to detect acute & chronic hepatitis C infection
  2. Serum HCV RNA qualitative & quantitative assay by PCR method
    to establish viremia & is employed in the management of chronic HCV infection
  3. Genotyping of HCV RNA (genotype 1-less Rx responsiveness, or genotype 2 or 3 with better Rx responsivenss)
    The 1998 studies of interferon and ribavirin combination therapy showed important differences in the outcome based on genotype; that is, approximately 30% of patients with genotype 1 and approximately 65% with genotype 2 or 3 had sustained virologic responses. In addition, patients with genotype 1 had higher rates of sustained virologic response with 48 weeks of combination therapy than with 24 weeks of therapy, whereas patients with other genotypes achieved no additional benefit beyond 24 weeks of therapy.   These studies have led to the practice of administering therapy for 12 months to patients with genotype 1 but for only 6 months to those with genotype 2 or 3. Factors in addition to genotype are known to predict the likelihood of successful therapy with ribavirin and interferon.

 

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10262004