Lab Med Online.  2019 Oct;9(4):210-217. 10.3343/lmo.2019.9.4.210.

Result Patterns and Characteristics of HBeAg and HBV DNA in Patients with Chronic Hepatitis B

  • 1Department of Laboratory Medicine, U2 Clinical Laboratories, Jangwon Medical Foundation, Seoul, Korea.


Discrepancies in the results between hepatitis B e-antigen (HBeAg) and hepatitis B virus (HBV) DNA levels pose difficulties in the management of chronic hepatitis B (CHB). This study aims to better understand the different phases of CHB and to detect additional meaningful parameters for CHB patients.
We collected datasets of HBeAg and HBV DNA levels measured during 2016 and the follow-up results for CHB patients for past 3 years. We analyzed the collected data by applying the definitions of CHB clinical phase and compared the results of semi-quantitative and quantitative HBeAg assays.
About 55% of 2,291 result pairs from CHB patients showed qualitative agreement between HBeAg and HBV DNA results. HBeAg (−) CHB was reported in 16.49%, while hepatitis B surface antigen (HBsAg) loss occurred in 0.18% among 1,146 patients annually. HBeAg reversion occurred in 2.74% of 839 patients that experienced HBeAg seroconversion. Patients with HBeAg (+) and HBV DNA (−) showed statistically significant differences in the levels and percentage abnormality of alanine aminotransferase (ALT) based on whether HBV DNA was "˜Target not detected' or "˜Detected, CONCLUSIONS
This study reveals clinically important result patterns during the different phases of CHB. ALT level and percentage abnormality were significantly different based on HBV DNA status in HBeAg (+) and HBV DNA (−) patients. We suggest that clinical laboratories should report "˜HBV DNA (−)' separately as "˜Target not detected' and "˜Detected,


HBeAg; Viral DNA; Chronic hepatitis B; Alanine aminotransferase; HBsAg

MeSH Terms

Alanine Transaminase
DNA, Viral
Follow-Up Studies
Hepatitis B
Hepatitis B e Antigens*
Hepatitis B Surface Antigens
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Alanine Transaminase
DNA, Viral
Hepatitis B Surface Antigens
Hepatitis B e Antigens


  • Fig. 1 Distribution of clinical factors of chronic hepatitis B patients with different clinical phase. (A) Persistent duration. (B) Sex proportion. Boxs represent the interquartile range, and the line within box represent the median. The data in the bar indicate the number of sex-specific patient. Symbol **represent P value less than 0.01. Abbreviations: IT, immune-tolerant; IA, immune-active; ER, HBeAg reversion; II, immune-inactive; IE, immune-escape.

  • Fig. 2 HBeAg levels of chronic hepatitis B patients with different clinical phase. Boxs represent the interquartile range, and the line within box represent the median (A box [first] of HBeAg[+]_IA group shows only bottom part). The horizontal red dashed line indicates the cut-off value (1.00 S/CO). Symbol ***represent P value less than 0.001. Abbreviations: IA, immune-active; ER, HBeAg reversion; II, immune-inactive; HBeAg, hepatitis B e-antigen; S/CO, signal to cutoff.

  • Fig. 3 Correlation between the semi-quantitative HBeAg and the quantitative HBeAg levels in 111 patients with chronic hepatitis B. (A) Regression plot. (B) % Difference plot. Abbreviations: HBeAg, hepatitis B e-antigen; S/CO, signal to cutoff.


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