Stages of Hepatitis B infection

The five stages of Hepatitis B infection are

• Immune tolerance,

• Immune active,

• Inactive HBV carrier state,

• HBeAg-negative chronic hepatitis B, and

• Hepatitis B surface antigen (HBsAg)-negative
  

Chronic hepatitis B (CHB) is when hepatitis B surface antigen (HBsAg) persists for six months or more. Most infected persons are unaware of their HBV infection and present advanced disease.

Annually, between 0·5% and 3% of inactive HBV carriers lose HBsAg. Spontaneous HBsAg clearance usually confers a good prognosis if there is no pre-existing hepatocellular carcinoma or cirrhosis at the time of HBsAg seroclearance (the clearance or removal of an antigen from the blood.) Following the loss of HBsAg, seroconversion to antibody against hepatitis B surface antigen (anti-HBs) is more likely to stop the development of cirrhosis and hepatocellular cancer, and it shows immunity to HBV and may suggest a better prognosis.

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