Medical Microbiology

432 8 VirusesasHumanPathogen

Diagnosis.HepatitisBisdiagnosedbyidentifyingthevariousHBVantigens

ortheantibodiesdirectedagainstthem.Bothantigensandantibodiescanbe

detectedinpatientbloodusingasolidphasetest(enzymeimmunoassay).

Theindividualcomponentsmanifestinspecificpatterns.Fig.8. 11 shows

thesequenceofphasesinanuncomplicatedhepatitisBinfection,uponwhich

theguidingprinciplesinlaboratorydiagnosisofHBVinfectionsarebased

(Table8. 1 ).

ThehepatitisDvirusisdiagnosedbydetectionofdeltaantigenorpossibly

antibodiestodelta(IgM)intheblood.

SerologicalMarkersinAcuteHepatitisB

Incubation period

4–12 weeks

Acute

2–12 weeks

Postacute

2–16 weeks

Postinfection phase

HBs antibodies

HBe antibodies

HBc antibodies

HBe antigen

HBs antigen

Fig.8. 11 Typicalantigenandantibodyconcentrationcurvesafterinfection.

Tab.8. 1 LaboratoryDiagnosticsinHBVInfections

Status Diagnostictest

Acuteinfection HBc-IgM,HBs-Ag

Vaccineimmunity HBs-IgG

Recovered,healed HBs-IgG,HBc-IgG

Chronic,patientinfectious HBeandHBs-Ag,PCR

ExclusionofHBV HBc-IgGnegative

Serologyinconclusive,mutants,therapeuticmonitoring QuantitativePCR

8

Kayser, Medical Microbiology © 2005 Thieme