What is the reason for the positive result of hepatitis B e antibody test

Hepatitis B e antibody positive may be caused by hepatitis B virus infection recovery period, hepatitis B virus variation, mother to child transmission and other factors. The positive E antibody of hepatitis B usually indicates that the virus replication is weakened or stopped, but the specific situation needs to be comprehensively judged in combination with other five indicators of hepatitis B.

1. Recovery period of viral infection

When hepatitis B virus infection enters the recovery stage, e antibody may be positive. At this time, the DNA load of hepatitis B virus in vivo is low or undetectable, accompanied by the production of surface antibodies. This situation indicates that the immune system has controlled virus replication and the infectivity has significantly decreased. The treatment is mainly based on regular reexamination of liver function and hepatitis B virus DNA, without special medication.

2. Precore mutation

Precore gene mutation of hepatitis B virus may lead to the inability to secrete e antigen and the situation that e antibody is positive but the virus is still actively replicating. Such patients may have repeated abnormal liver function, which needs to be confirmed by hepatitis B virus DNA test. Antiviral drugs such as entecavir tablets and tenofovir disoproxil fumarate tablets can be used for treatment, and the degree of liver fibrosis should be monitored regularly.

3. Mother to child vertical transmission

Newborns infected with hepatitis B virus through mother to child transmission may show positive e antibody with positive core antibody. Such children need to be tested for hepatitis B surface antigen to confirm the infection status, and if confirmed, long-term follow-up is required. The treatment plan includes strengthening the vaccination of recombinant hepatitis B vaccine, and using interferon α -2b injection for immune regulation when necessary.

4. Occult hepatitis B infection

Some patients have negative surface antigen but hepatitis B virus DNA, showing positive e antibody. This situation may be related to mutations in the S gene of the virus, which can easily lead to missed diagnosis. It is suggested to carry out highly sensitive hepatitis B virus DNA detection, select Amitinofovir tablets and other drugs to control virus replication after diagnosis, and screen liver cancer markers at the same time.

5. Post vaccination reaction

Transient positive e antibody may appear after hepatitis B vaccination, which belongs to normal immune response. This situation is usually accompanied by positive surface antibodies and negative virological indicators. No special treatment is required, but it needs to be distinguished from the real infection, which can be confirmed by tracking the dynamic changes of antibodies.

When hepatitis B e antibody is positive, the five quantitative tests, liver function and virus DNA tests of hepatitis B should be improved. Strict abstinence from alcohol is necessary in daily life, avoiding the use of hepatotoxic drugs, and maintaining a high-quality protein diet such as fish and soy products. Liver ultrasound and alpha fetoprotein should be rechecked every 3-6 months, and patients over 40 years old are recommended to undergo liver hardness testing to evaluate the degree of fibrosis. If combined with elevated transaminase levels or virus positivity, antiviral treatment should be standardized under the guidance of an infectious disease specialist.