Definitions and terms used in hepatitis B virus infection
| Definition | Diagnosis | |
|---|---|---|
| Adapted from Lok and McMahon and de Franchis et al.12,13 | ||
| *Optional; †HBeAg (+) = HBeAg positive chronic hepatitis B or HBeAg (−) = HBeAg negative chronic hepatitis B. | ||
| HBsAg, hepatitis B surface antigen; ALT, alanine aminotransferase; AST, aspartate aminotransferase; anti-HBc, antibody to hepatitis B core antigen; HBV, hepatitis B virus; HBeAg, hepatitis B e antigen; anti-HBe, antibody to hepatitis B e antigen. | ||
| Acute hepatitis B | Acute hepatic injury that develops within 6 months after exposure to the virus and resolves within 6 months after onset of symptoms | HBsAg (+) ↑↑↑ ALT/AST ↑↑↑ IgM anti-HBc |
| Chronic hepatitis B | Chronic necroinflammatory disease of the liver caused by HBV | HBsAg (+) for >6 months Serum HBV DNA (+) (>105 copies/ml) ↑ ALT/AST (persistently or intermittently) Chronic hepatitis in liver biopsy (necroinflammatory score ⩾ 4)* HBeAg ±† |
| Inactive HBsAg carrier state | Chronic HBV infection characterised by: | HBsAg (+) for > 6 months HBeAg (−)/Anti-HBe (+) Persistently normal ALT/AST (serial testing for 1 year) Serum HBV DNA levels (<105 copies/ml) (serial testing for 1 year) Absent or minimal liver necroinflammation in liver biopsy (necroinflammatory score < 4)* |
| Resolved HBV infection | HBsAg (−) Serum HBV DNA (−) Normal ALT levels Known history of acute/chronic hepatitis B or anti-HBc (+)/anti-HBs± | |
| Occult HBV infection | HBsAg (−) HBV DNA (+) in serum/liver Anti-HBc ±, Anti-HBs± | |