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Medicine

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Liver & GIT

Question
9 out of 14
 

A thirty-year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/1900 IU/ml. The serological tests showed presence of HBsAg. IgM anti-HBc and HbeAg. The most likely diagnosis is:



A Chronic hepatitis B infection with high infectivity.

B Acute hepatitis B infection with high infectivity.

C Chronic hepatitis infection with low infectivity.

D Acute hepatitis B infection with low infectivity.

Ans. B Acute hepatitis B infection with high infectivity.

Serology of Hepatitis B

HBsAg

Anti HBsAb

HBe Ag

Anti HBeAb

Anti HBcAb

Acute HBV (with high infectivity)

+

-

+

IgM

Acute HBV with low infectivity)

+

-

-

+

IgM

Chronic HBV (High infectivity)

+

-

+

IgG

Chronic HBV (low infectivity)

+

-

-

+

IgG

Extra Edge:

1. HBs Ag would be positive even in chronic infection and hence cannot be used to establish a diagnosis of acute Hepatitis B infection.

2. HBsAg Present in acute infection, chronic infection and carrier state.

3. HBeAg = Active, infective disease

4. HBs Ab = Its presence is safe for blood transfusion.

HBs Ag

Anti HBs ab

Indicates that the person is infected with the virus. The infection may manifest as ‘disease’ either acute or chronic, or be just present as in carrier state.

Hbs Ag thus indicated as possible:

i. Acute disease

ii. Chronic disease

iii. Carrier state

With the development of antibody to Hbs Ab i.e. Anti Hbs Ab, the Hbs antigen disappears from the serum.

Anti Hbs Ag indicates good immunity.

Anti Hbs Ag indicates protection against Hep B

HBcAg

Anti HBc Ab

It is a hidden component of the viral score and is not detectable at all

Develop early in the course of disease

It is the first antibody to appear after an acute infection and persists in serum even during the recovery phase

- When acute antibody is of IgM type

- When chronic antibody is of IgG type

Hbe Ag

Anti Hbe Ab

Denotes high infectivity and active disease

Denotes low infectivity

Liver & GIT Flashcard List

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