A Misleading Pattern of Serologic Findings During Hepatitis B Virus Infection
Authors: Gil Ben-Yakov, Kapuria Devika, Ohad Etzion, Christopher Koh, Theo Heller
Journal: Annals of Internal Medicine (2017)

Letters17 October 2017A Misleading Pattern of Serologic Findings During Hepatitis B Virus InfectionGil Ben-Yakov, MD, Kapuria Devika, MD, Ohad Etzion, MD, Christopher Koh, MD, MHSc, and Theo Heller, MDGil Ben-Yakov, MDFrom National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, Kapuria Devika, MDFrom National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, Ohad Etzion, MDFrom National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, Christopher Koh, MD, MHScFrom National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Search for more papers by this author, and Theo Heller, MDFrom National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0369 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The most widely recognized feature of hepatitis B virus (HBV) infection is a positive result on blood testing for hepatitis B surface antigen (HBsAg). In patients with acute infection that resolves, HBsAg usually becomes undetectable within a few months and IgG antibody to hepatitis B core antigen becomes detectable at approximately the same time; only later does antibody to HBsAg appear. When HBV infection is chronic, HBsAg is produced continuously in large amounts, hepatitis B core antibody is present, and HBsAg antibody is absent (1). Approximately 1.6% of persons with chronic HBV infection have spontaneous loss of HBsAg each ...References1. Gogoi D, Borkakoty B, Biswas D, Mahanta J. Activation and exhaustion of adaptive immune cells in hepatitis B infection. Viral Immunol. 2015;28:348-53. [PMID: 26331345] doi:10.1089/vim.2014.0115 CrossrefMedlineGoogle Scholar2. Tseng TC, Liu CJ, Yang HC, Su TH, Wang CC, Chen CL, et al. Determinants of spontaneous surface antigen loss in hepatitis B e antigen-negative patients with a low viral load. Hepatology. 2012;55:68-76. [PMID: 21858846] doi:10.1002/hep.24615 CrossrefMedlineGoogle Scholar3. Makvandi M. Update on occult hepatitis B virus infection. World J Gastroenterol. 2016;22:8720-34. [PMID: 27818588] CrossrefMedlineGoogle Scholar4. Fong TL, Di Bisceglie AM, Gerber MA, Waggoner JG, Hoofnagle JH. Persistence of hepatitis B virus DNA in the liver after loss of HBsAg in chronic hepatitis B. Hepatology. 1993;18:1313-8. [PMID: 8244254] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0369.This article was published at Annals.org on 29 August 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 October 2017Volume 167, Issue 8Page: 603-604KeywordsDNAGenetic testingHepatitis AHepatitis BHepatitis B surface antigenHepatitis B virusInfectious hepatitisLiver fibrosisSerum glutamic oxaloacetic transaminaseViral load ePublished: 29 August 2017 Issue Published: 17 October 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...