What Does a Positive Anti-Hepatitis B Virus e Antibody Test Mean?

A positive anti-hepatitis B virus e antibody (anti-HBe) result indicates that this specific antibody has been detected in the patient's blood. This antibody is produced by the immune system in response to the hepatitis B virus e antigen (HBeAg), but it is not a protective antibody and does not provide immunity against the virus. A positive anti-HBe result can occur under different scenarios, as explained below.

Previous Infection with Hepatitis B Virus

One common situation where anti-HBe is positive is after a past infection with the hepatitis B virus (HBV). In such cases, the immune system may have successfully cleared the virus from the body, but certain antibodies, including anti-HBe and core antibody (anti-HBc), may remain positive for a long time. Sometimes, the surface antibody (anti-HBs) can also be present, indicating immunity. If liver function tests are normal and no hepatitis B surface antigen (HBsAg) is detected, this usually indicates a resolved infection and is considered a normal finding.

Chronic Hepatitis B Infection

Alternatively, a positive anti-HBe result can also be seen in individuals with chronic hepatitis B infection. In this case, the body has not effectively cleared the virus, and HBV continues to replicate in the liver. The presence of anti-HBe along with a positive HBsAg and core antibody typically indicates an ongoing infection. This pattern is often associated with lower levels of viral replication, but the virus is still present and can cause liver damage over time.

Distinguishing Between Past and Chronic Infection

To determine whether the anti-HBe positivity reflects a past infection or chronic disease, additional blood tests are necessary. These include checking for the presence of HBsAg, anti-HBs, and HBV DNA levels. These tests help doctors assess the stage of infection and decide whether treatment or monitoring is needed.

In summary, a positive anti-HBe result alone does not confirm whether someone has a current infection or has recovered from a past infection. Further testing is essential to understand the full picture and to make informed medical decisions. If you receive such a result, it is important to consult a healthcare provider for a comprehensive evaluation.