Hepatitis B Virus e Antibody, Serum (LAB796) and Hepatitis B Virus e Antigen, Serum (LAB908)

HBeAg and HBeAb are monitoring tests and should be only ordered if the HBsAg is positive.

Clinical Background
  • HBeAg and HBeAb are used to monitor the progression from chronic active HBV (HBeAg+ and HBeAb-) to inactive carrier (HBeAg- and HBeAb+).  It is important to differentiate between these two states because active HBV is associated with liver damage and increased risk of hepatocellular carcinoma. 
  • Patients are stratified to treatment differently depending upon HBeAg status.
Common Pitfalls
  • If the HBsAg is negative, it is unlikely that the patient is chronically infected or a carrier; therefore, HBeAg and HBeAb are not indicated
  • Mutations can develop in the HBeAg (core and pre-core mutations) which can lead to a loss of expression of this protein and hence mask chronic infection. 
  • HBeAg and HBeAb are performed in-house and used to assess hepatitis B status and NOT hepatitis E IgG/ IgM, which is a send out to Mayo Clinic.
Key Takeaways
  • HBeAg and HBeAb are monitoring tests and should be only ordered if the HBsAg is positive.
  • The distinction of HBeAg negative chronic HBV can be assessed using a combination of other markers: HBsAg positive, HBeAg negative, HBeAb positive, detection of HBV DNA, and evidence of hepatic injury (elevated LFTs, and histologic evidence).
References
  1. Buchan BW, Anderson NW, Virology, (2023) Tietz Textbook of Laboratory Medicine 7th Edition, Elsevier
  2. Parikh BA, Anderson NW, Virology, (2023) Clinical Microbiology Procedures Handbook 5th Edition, ASM Press

Written by: Patricia Hernandez, MD

Reviewed by: Neil Anderson, MD

Last Edited: 2024-08-29

Last Reviewed: 2024-08-29