Serology of acute and chronic type B hepatitis

Hepatitis B infection remains a clinically important cause of acute and chronic hepatitis worldwide. New information, based on the detection in serum of HBV markers has allowed new insight into the behavior of the virus in acute and chronic infection. The serology of an acute, self-limited infection remains relatively simple and is based on a typical rise and fall in HBsAg and IgM anti-HBc levels with subsequent production of anti-HBs. A better understanding of viral behavior in chronically infected individuals has led to the designation of replicative and nonreplicative phases. If used in conjunction with liver biopsy findings, these newer divisions allow a clearer understanding of variations in serology, clinical course and ultimate outcome than was possible previously. Finally, with the introduction of hepatitis B vaccines and promising early results from studies designed to treat chronic infection, we may at last be making progress in this major health problem.