Hepatitis B Envelope Antigen (HBeAg)

What does Hepatitis B Envelope Antigen (HBeAg) mean?

Hepatitis refers to liver inflammation caused by a viral infection. This is one of the most widespread and contagious diseases in the world with more than 400 million people being a carrier of the hepatitis B virus. When the hepatitis B virus is actively circulating and replicating in the blood, it produces the hepatitis B antigen protein. The presence of this antigen protein means that the person is infected with the virus and can spread the infection to other people.

What is the HBeAg test?

The HBeAg test is used to detect the presence of the active hepatitis B virus. If a person is infected with this virus, the level of HBeAg and also HBsAg (surface antigen) will be high. The presence of HBeAg in the blood is associated with hepatitis B virus (HBV) infectivity, the number of infectious virions present in the body, and the presence of HBV core antigen in the infected liver cells.

What are the different types of Hepatitis B?

In most of the adult cases of hepatitis B (almost 95%), the virus is completely cleared from the body upon treatment. However, the remaining 5% can go on to develop chronic forms of the disease. It has been observed that within 6 months of the treatment, most people not only clear the virus but also become immune to the same. In general, there are 3 distinct types of hepatitis B infections seen:

Healthy Chronic Carriers
These people carry the virus but don’t develop any symptoms. They are not infectious to others but have a higher risk of developing hepatic conditions such as cirrhosis. However, if the immune system in such individuals gets suppressed owing to an infection (HIV/AIDS) or treatment via immunosuppressant drugs, there are chances that they may develop hepatitis B infection.

Chronic Infectious Carriers
They are the contagious carriers of the disease as they have virus replicating in their systems. They show signs of hepatitis such as damaged liver that progresses into liver cirrhosis. Only 5% of the cases can show remission of the virus.

Chronic Mutant
The chronic mutant form is a result of a mutated strain of the virus that causes permanent alteration to the hepatitis B virus’s genetic makeup. Those with it have the risk of being infectious to others and it is observed to be more resistant to treatment than other forms of hepatitis B.

Why is the HBeAg test performed?

The HBeAg test is often performed to
– Screen hepatitis B infection

– Diagnose whether the infection is acute or chronic in nature
– Detect the presence of an earlier hepatitis B infection and whether it has been resolved completely or not
– Monitor the efficacy of the current treatment of hepatitis B

Why has my doctor asked me to undergo an HBeAg test?

Your doctor will ask you to undergo this test if you show

– Signs and symptoms of HBV infections such as jaundice, abdominal pain, digestive disorders, and dark urine.
– High ALT levels (alanine aminotransferase)
– Signs of immunosuppression if undergoing cancer treatment.
– Are undergoing hepatitis C treatment.
– If you need to undergo hepatitis immunization.

What is the price of the HBeAg test in India?

The cost of the HBeAg test in India can range between Rs. 800 to 1000, depending upon the city and the diagnostic facilities available.

How is the HBeAg test performed?

The HBeAg test follows the routine steps of a typical venipuncture test.

– The blood sample is collected from the arm. The healthcare provider will rub an antiseptic solution on the opposite side of your elbow and tie a tourniquet around your arm.

– This tourniquet will increase the pressure of blood in the veins and thus make it easy to find the right vein.

– Once the vein has been located, a syringe will be inserted and a small amount of blood will be withdrawn and collected in a vial.

– The puncture site is covered with sterile gauze to prevent further bleeding and infection.

– The blood sample is then sent to the laboratory for testing for the presence of active hepatitis B virus presence.

Does the test require fasting?

Fasting is not required for an HBeAg test.

How should I prepare for the HBeAg test?

There are no specific preparations such as fasting are required for the HBeAg test.

How to understand the HBeAg test result?

When performed as a part of the Hepatitis B virus screening, the following is the interpretation of the test.

What should I know about the Hepatitis B Envelope antigen?

An antigen is a protein that stimulates an immune system response, that triggers the body’s tendency to produce antibodies and combat the microbial invasion. To test for the presence of hepatitis B, the other antigen tests that are performed ar – HBsAg (surface antigen) and HBcAg (core antigen). These antigens are attached to the inside and the outside of the virus.

The hepatitis B e-antigen is distinct from these two antigens. It’s a protein that the virus manufactures and secretes during the process of rapid multiplication. It isn’t circulating while attached to the virus but instead is free in your bloodstream and tissues. Hence, it means that if the result of this test is positive, not only does the person have hepatitis B, he/she has the potential to pass it on to other people too.

Is the HBeAg test recommended during pregnancy?

Pregnant women need to undergo screening for a different antigen, the hepatitis B surface antigen (HBsAg) that also indicates an active infection with the hepatitis B virus.

If the test result for HbsAg is positive, the HBeAg test may be done, along with tests such as the HBV DNA concentration test and alanine aminotransferase (ALT) test for testing the liver function.

If the HBeAg test is positive, a pregnant woman should be referred to a specialist immediately for care until delivery. Irrespective of the result of the test of HBeAg, once the baby is born, it will require active immunization against the hepatitis B virus.

Is the HBeAg test prescribed for infants and children?

Babies who are born to mothers with hepatitis B virus need to undergo special screening, care, and treatment for the same. The follow up of such babies includes proper immunization of HBIG at birth and the following months. In the case of children, if they have symptoms of liver inflammation, as discussed before, they need to undergo the HBeAg blood test as well.