Hepatitis

Question 1

Hepa B intro

Answer 1

• long asymptomatic incubation period (lasting an average of 6-8 weeks)
• followed by acute disease lasting several weeks to months.

1. HBsAg first appears before the onset of symptoms, peaks when the patient is most ill, and then becomes undetectable in 3-6 months (unless the disease progresses to a chronic phase).
2. Shortly after HBsAg first appears, HBeAg and HBV DNA can be detected in the serum and are markers of active viral replication.
3. Anti-HBcAg IgM and elevated serum transaminases appear shortly before symptom onset.
4. Over the next few months, the anti-HBcAg IgM component is replaced with an IgG component.
5. Anti-HBeAg appears shortly after HBeAg vanishes and suggests subsiding viral activity (transition from high viral replication/infectivity to
   low viral replication/infectivity).
6. Anti-HBsAg IgG arises once the acute disease has resolved (unless the disease progresses to a chronic phase), and is not detectable until weeks or months after HBsAG has disappeared.

Question 2

acute hepatitis B infection that has not resolved, but rather has progressed to a highly infectious chronic hepatitis B (note the persistence of HBeAg and lack of anti-HBeAg).

Answer 2

persistence of HBsAg and HBeAg over a long period with low to moderate levels of anti-HBcAg IgG and no detectable Anti-HBsAg.

Question 3

fully recovered

Answer 3

all antigens should have dropped to undetectable levels and he should have high levels of anti-HBsAg IgG and anti-HBcAg IgG.

Question 4

Acute hepatitis B that progressed to chronic hepatitis with low infectivity

Answer 4

low or undetectable levels of HBeAg (the marker for high infectivity) and likely detectable quantities of anti-HBeAg.