Hepatitis B e Antibody: Treatment Outcomes and Longevity

Q: Hepatitis B e Antibody: Treatment Outcomes and Longevity

1. <br>In chronic hepatitis B patients who are e-antigen positive and have liver enzyme levels more than twice the normal limit, after six months of antiviral medication, if the viral load is undetectable, it cannot be considered a cure. <br>The treatment goal is to continue unti

Hepatitis B e antibody (anti-HBe)

Hello Dr.
Lin, I would like to ask you: If after taking antiviral medication for six months, the blood test shows e-antibody <1, but the e-antigen is still positive and the viral load is undetectable, does this still indicate that the patient is not cured? Additionally, will the e-antibody persist for life or can it disappear? Thank you.

Lin Yaqi, 40~49 year old female. Ask Date: 2015/12/28

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
In chronic hepatitis B patients who are e-antigen positive and have liver enzyme levels more than twice the normal limit, after six months of antiviral medication, if the viral load is undetectable, it cannot be considered a cure.
The treatment goal is to continue until e-antigen disappearance and e-antibody production, followed by normalization of liver function, and then to maintain consolidation therapy for one year.
2.
Antiviral medication for hepatitis B is aimed at controlling the disease, reducing viral load, and decreasing the incidence of inflammation, cirrhosis, and liver cancer, but it cannot be considered a cure.
After seroconversion from e-antigen positive to e-antibody positive, a small portion of patients may revert to e-antigen positive and e-antibody negative after stopping medication or under certain conditions.
Therefore, follow-up is still necessary after the treatment course is completed.
Dr.
Lin Ming-Hui, attending physician of the Department of Hepatobiliary and Gastroenterology at Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/28

More Info

Hello! Thank you for your question regarding the treatment outcomes of Hepatitis B, specifically concerning the e antibody (anti-HBe) and its implications for recovery.

When it comes to Hepatitis B treatment, the presence of e antigen (HBeAg) and the corresponding e antibody (anti-HBe) are critical markers for assessing the disease's status and treatment effectiveness. In your case, if you have been on antiviral therapy for six months and your e antibody level is less than 1 while the e antigen remains positive, it indicates that you have not yet achieved a complete response to the treatment. The goal of antiviral therapy is not only to suppress the viral load but also to achieve seroconversion, which means that the e antigen should turn negative and the e antibody should become positive.
The fact that your viral load is undetectable is a positive sign, as it suggests that the antiviral medication is effectively controlling the virus. However, the persistence of e antigen positivity indicates ongoing viral activity, which means that the infection is still present, and you are not yet considered "cured." A complete cure would typically be defined by the loss of HBsAg (Hepatitis B surface antigen) and the presence of anti-HBs (Hepatitis B surface antibody), along with the seroconversion of e antigen to e antibody.

Regarding the longevity of the e antibody, it is important to note that while e antibodies can remain in the system for a long time, they may not necessarily be permanent. In some cases, e antibodies can decline or even disappear over time, especially if the underlying viral infection is not fully resolved. This is why continuous monitoring is crucial in managing chronic Hepatitis B.

In summary, while your current treatment appears to be effective in controlling the virus, the presence of e antigen and the low level of e antibody suggest that you have not yet reached a state of complete recovery. It is essential to continue your antiviral therapy as prescribed and to have regular follow-ups with your healthcare provider to monitor your liver function and viral load. Your doctor may also consider additional tests to evaluate your liver health and determine the best course of action moving forward.

If you have further questions or concerns about your treatment plan or the implications of your lab results, I encourage you to discuss them with your healthcare provider. They can provide personalized guidance based on your specific situation and medical history. Thank you for your inquiry, and I wish you the best in your treatment journey!

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