Handling When HBsAg Examination Results Are Negative?
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In hepatitis B, there are a number of markers (markers) serologic that are important for the diagnosis of disease and for tracking the disease development process, because in some cases, 5% -10% can develop into a healthy carrier (still contains a virus but does not develop into a disease), 4% can occur with persistent B virus infection. The 10% -33% of persistent hepatitis B virus infection can progress to chronic hepatitis B, which can further develop into cirrhosis of the liver and liver cancer type hepatocellular carcinoma. Also in some patients, co-infection or super-infection with the hepatitis D virus can occur. Therefore, regular monitoring is needed for every hepatitis B sufferer, despite clinical improvement.
Hepatitis B markers are:
HBsAg. This marker has been detected before the onset of symptoms. The climax when clinical symptoms become apparent. This marker decreases or is not detected after 12 weeks, but in some patients it disappears after 24 weeks of Anti-HBsAg. This marker does not increase until the disappearance of acute disease, along with the disappearance of HBsAg. Sometimes anti-HBsAg only appears after an interval of several weeks or even months after the disappearance of HBsAg. This situation is known as the window period. This marker can last a lifetime, and form the basis of hepatitis B virus HBeAg, HBV DNA and HBV DNA polymerase vaccination strategies. Is a sign of acute hepatitis B virus replication. These markers were detected shortly after the appearance of HBsAg. If HBeAg continues to be detected continuously, it is necessary to consider the threat of disease continuation toward chronic Anti-HBe hepatitis B. The emergence of HBe indicates that the acute disease has reached its peak and is gradually easing anti-HBc IgM. Detected in the serum precedes the appearance of clinical symptoms. Increased anti-HBc IgM generally occurs along with an increase in serum transaminases. The serum transaminases are indicators of injury to the anti-HBc IgG liver cells. After a few months, the anti-HBc IgM gradually disappears and is replaced by the anti-HBc IgG. If there is a suspicion of co-infection or super-infection with hepatitis B virus, an examination of HDV RNA and IgM anti-HDV is also carried out.
In addition, it should be noted that there are occasionally strains of hepatitis B virus that do not produce HBeAg, which as described above are indicators of active viral replication. Nevertheless, the strain still has an active replication capacity. This is characterized by HBeAg being negative even though HBV DNA remains high. It is suspected that this occurs due to mutation of the hepatitis B virus, as one way to avoid the body's defense mechanisms that are induced by mutations (vaccine-induced escaped mutants). But this needs to be tested through medical or biomedical research.
If after repeated examinations it is found that HBeAg which has been negative together with anti-HBe which was previously positive has now become negative, then this seems to indicate the disease has gradually subsided. However, because of the risk of vaccine-induced escape mutants, it doesn't hurt that you consult your doctor so far about whether you need HBV DNA testing in your case. Because the best person to know your medical history is the doctor who has been handling you, and continuous consultation and medical check-up in cases of hepatitis B is essential. The anti-HBsAg generally last a lifetime.
Thus information from me, hopefully can help.