A patient presented with acute onset of jaundice and raised aminotranferases. Preliminary serology repo showed HBsAg positivity. On fuher testing, which of the following is least likely to be found in this patient?
High-Yield Explanation
HBsAg appears before the onset of symptoms and peaks in acute, symptomatic disease. HBsAg persists in cases of chronic hepatitis B. Anti-HBs antibody begins to rise following the resolution of acute disease, generally after the disappearance of HBsAg. Anti-HBs antibodies tend to persist for life, conferring protection; this is the basis for current vaccination strategies using noninfectious HBsAg. By contrast, anti-HBs antibodies are not produced in cases that progress to chronic liver disease. HBeAg, HBV DNA, and HBV DNA polymerase are detectable in the serum soon after HBsAg and signify active viral replication Persistence of HBeAg is an impoant indicator of continued virus replication, infectivity, and probable progression to chronic hepatitis. Anti-HBe antibody signifies that acute infection has peaked and is on the wane, whereas in cases that progress to chronic infection, anti-HBe antibody is not produced or appears only late in the disease course.