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  Laboratory Diagnosis

Laboratory Diagnosis:

Serology depends on detection of viral antigens and antibodies, employing RIA, ELISA.

Viral antigens:

1. Surface antigen (i.e., HBsAg) is secreted in surplus into the blood as 22 nm spheres and tubules. Its existence in serum points out that virus replication taking place in the liver.

2 ‘e’ antigen (i.e., HBeAg) secreted protein is shed in small quantities into the blood. Its presence in serum points out that a high level of viral replication is taking place in the liver.

3. Core antigen (i.e., HBcAg) core protein is not found in blood.

Antibody response:

1) Surface antibody (i.e., anti-HBs) becomes noticeable late in convalescence, and points out immunity following infection. It stays detectable for life and is not found in chronic carriers.

2) e antibody (i.e., anti-HBe) becomes detectable as viral replication falls. It points out low infectivity in a carrier.

3) Core IgM rises early in infection and points out recent infection.

4) Core IgG increases rapidly after IgM, and remains present for life in both chronic carriers and also those who clear the infection. Its presence points out exposure to HBV.

Prevention:

1) Active Immunization:

Two kinds of vaccine are available:

Serum derived: prepared from HBsAg cleanse from the serum of HBV carriers

Recombinant HBsAg: prepared by genetic engineering in yeasts.

Both vaccines are uniformly safe and efficient. The administration of three doses comprises protective levels of antibodies in 95 percent of vaccine recipients. The universal immunization of infants was introduced in April 1995. Infants receive 3 doses at 6, 10 & 14 weeks of age. Vaccine must be administered to people at high risk of infection with HBV:

A. Health care workers
B. Sexual partners of chronic carriers
C. Infants of HBV carrier mothers.

2) Passive Antibody:

Hepatitis B immune globulin must be administered to non immune individuals obeying single episode exposure to HBV-infected blood. For illustration: needle stick harms.

 

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