HBeAg negative and HBeAb positive

[bram44]

It appears HBeAg negative and HBeAb positive patients may have core or precore mutations, which results in active replication of virus.

When I had Genotype test it came out as follows :
      Hepatits B virus Genotype    A
     Plymerase mutations            NOT DETECTED
     PRECORE MUTATIONS       NOT DETECTED
     BCP MUTATIONS                NOT DETECTED

Tests also mentioned no resistance predicted for treatment with 5 approved drugs. Did not mention VIREAD in the list, probably being a new drug. I am currently taking VIREAD.

Does this mean I am an inactive carrier ?  

[bram44]

Thanks for the info.

If there is no mutation, can there be better prognosis for HBeAg -ve patients ?

I will share my viral load after 3 months on viral treatment. Before treatment counts were 90000 copies/ml and 30000 IU/ml.  Usualy IU vs count will be 1 to 5 times.

It is kind of interesting to see HBeAb +ve, yet there is active replication.

[Sharp7]

HBeAg -ve people typically would have low viral replication -- in many cases, low enough to require no further treatment. If the DNA VL is high for Ag -ve people, it means that they have active viral replication despite their Ag -ve. Hence the treatment.

In general Ag +ve people fare worse than Ag -ve people, but keep in mind that this *by itself* is not a criterion for a prognosis or for starting treatment.

[bram44]

On one hand the goal for treating HBeAg + patients is to get sero conversion (then stop treatment), the other HBeAg -ve it is open ended.

It is some what confusing to read HBeAg -ve/HBeAg anti-bodies +ve patients have low viral replication, but still require treatment. Where as HBeAg +ve patients treatment stops with sero conversion.

Is this because with treatment HBeAg +ve patients are converted to HBeAg -ve sooner and have better liver health, thus do not require treatment ?

[Sharp7]

Genotype: it could influence a decision to start treating with peginterferon. A and B are relatively more easily brought under control than C and D. The genotype also gives  an indication as to how severe the disease is going to be.

precore/BCP: the jury still seems to be out.

[bram44]

What conclusions can be drawn from the "core/precore mutation tests" ?

Anyone know about this and the significance of GenoType ?

[bram44]

Is the test I had mentioned at the beginning a confirmation that there is no pre-core/core mutations ?

Or this test is not that useful ?

Any comment is appreciated.