Useful markers for distinguishing chronic hepatitis B phases

PhaseALTHBsAgHBeAgHBeAg antibodyHBV DNA (IU/ml)aLiver histology
Immune toleranceUsually normalPresentPresentAbsent≥20,000Usually normal; can have mild inflammation
Immune clearanceElevated; can be episodicPresentPresentAbsent≥20,000Active inflammation
Inactive HBsAg carrierUsually normal; can have flaresPresentAbsentPresent<20,000*Degree of abnormality dependent on disease severity during clearance phase (mild inflammation to inactive cirrhosis)
HBeAg CHBPeriodic flaresPresentAbsentPresent>20,000 or <20,000Active inflammation
Occult hepatitis BCan be elevatedAbsentAbsentPresent in recovered HBV infection<20,000†Ranges from normal to cirrhosis and HCC
  • a Symbols: *, can be undetectable by PCR; †, usually (often detectable only with highly sensitive molecular tests).