From the Guidelines
Anti-HBe signifies the presence of antibodies against the Hepatitis B e antigen, indicating lower viral replication and infectivity, and is often a favorable sign in chronic HBV infection, as it may indicate the immune system is controlling viral replication. This marker is typically used in conjunction with other tests like HBV DNA levels, liver enzymes, and other serological markers to fully assess HBV infection status and guide treatment decisions 1. The presence of anti-HBe usually indicates that the infection has transitioned from a highly infectious phase to a less infectious one, which can be a positive sign in the management of chronic hepatitis B. However, it's crucial to consider that some patients with anti-HBe positivity can still have active liver disease due to HBV variants.
Key Points to Consider
- Anti-HBe is an important marker in the assessment of HBV infection status, particularly in chronic hepatitis B patients.
- The presence of anti-HBe generally indicates lower viral replication and reduced infectivity.
- Anti-HBe positivity can be associated with a favorable outcome in chronic HBV infection, as it may signify the immune system's control over viral replication.
- However, the presence of anti-HBe does not rule out the possibility of active liver disease, especially in cases of HBV variants.
- A comprehensive assessment of HBV infection status should include multiple markers, such as HBV DNA levels, liver enzymes, and other serological tests, in addition to anti-HBe.
Clinical Implications
The interpretation of anti-HBe should be considered in the context of other clinical and laboratory findings. For instance, a patient with anti-HBe positivity and low HBV DNA levels may be considered to be in an inactive phase of the disease, whereas a patient with anti-HBe positivity and elevated HBV DNA levels may require closer monitoring or adjustment of treatment 1. The clinical implications of anti-HBe positivity should be evaluated in conjunction with other relevant markers and clinical findings to guide treatment decisions and management of chronic hepatitis B.
From the Research
Anti-HB(e) Significance
- The presence of anti-HB(e) signifies the conversion from HBeAg to anti-HBe in patients with chronic hepatitis B, which may indicate a resolved hepatitis B infection 2.
- Anti-HBe, when present without markers of virus replication, may serve as a sign of previous, completely resolved hepatitis B 2.
- The development of anti-HBe in patients with chronic hepatitis B may cast doubt on the assumption that HBeAg is a viral constituent, in favor of the hypothesis that the HBe/anti-HBe system is of host origin 2.
- In patients with acute hepatitis B, anti-HBe is typically present after a median period of 2 weeks after peak SGPT levels, and its presence is associated with the resolution of the infection 2, 3.
- The presence of anti-HBe in patients with chronic hepatitis B is associated with a lower level of viral replication and a reduced risk of liver-related complications, such as cirrhosis and hepatocellular carcinoma 4, 5.
Clinical Implications
- The detection of anti-HBe can be used to distinguish between acute and symptomatic chronic hepatitis B virus infection, in combination with other serological markers such as immunoglobulin M antibody to hepatitis B core antigen (anti-HBc) 6.
- The presence of anti-HBe can be used to monitor the response to antiviral treatment in patients with chronic hepatitis B, and to predict the risk of liver-related complications 4, 5.