A 29 year old male found HBsAg positive with highly increased SCOT levels but HBeAg negative. Which of the foUowing is true about the status ofthe patient -: (A) Precore mutant, (B) Core-promoter mutant, (C) Wild type mutant, (D) Surface mutant
Answer is A. Hepatitis B e antigen Hepatitis B e antigen (HBeAg) is an indicator of viral replication. In acute hepatitis B it may appear only transiently at the outset of the illness; its appearance is followed by the production of antibody (anti-HBe). The HBeAg reflects active replication of the virus in the liver. Chronic HBV infection (see below) is marked by the presence of HBsAg and anti-HBc (IgG) in the blood. Usually, HBeAg or anti-HBe is also present; HBeAg indicates continued active replication of the virus in the liver. The absence of HBeAg usually implies low viral replication; the exception is HBeAg-negative chronic hepatitis B (also called 'pre-core mutant' infection) , in which high levels of viral replication, serum HBV-DNA and hepatic necroinflammation are seen, despite negative HBeAg. Ref Davidson edition23rd pg875