A patient is diagnosed with chronic hepatitis B. HBsAg is positive for >6 months, HBeAg is positive, HBV DNA is 2×10^7 IU/mL, and ALT is 3× ULN. Which serological marker indicates active viral replication and correlates with infectivity?

• A Anti-HBc IgG positivity
• B Anti-HBs positivity
• C Anti-HBe positivity
• D HBeAg positivity ✓

Explanation

HBeAg (hepatitis B e antigen) is a soluble secreted protein derived from the precore/core region of HBV; its presence in serum indicates active viral replication and high infectivity. HBeAg-positive patients have higher HBV DNA levels and are more infectious. Anti-HBc IgG indicates past or current infection but not necessarily active replication. Anti-HBs indicates immunity (post-vaccination or recovery). Anti-HBe appears during seroconversion and generally indicates reduced viral replication, though anti-HBe-positive disease with precore mutants can still have active disease.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.