Hepatitis B requires the examination of five items: surface antigen, surface antibody, е antigen, е antibody, and core antibody. Here are the specific meanings of these five items:

1. Surface Antigen (HBsAg)

Determines the presence of Hepatitis B virus in the body.

2. Surface Antibody (Anti-HBs)

Determines if there is protective immunity.

3. е Antigen (HBeAg)

Determines if the virus is replicating and infectious.

4. е Antibody (Anti-HBe)

Determines if the replication of the virus is suppressed.

5. Core Antibody (Anti-HBc)

Determines if the individual has been infected with Hepatitis B virus.

In the process of Hepatitis B virus infection, a high level of anti-HBc can be detected during the acute phase. After the acute phase, the level of core antibody remains high and persists for several years. In chronic infection carriers or patients, the core antibody often remains at a high level. Additionally, patients with negative surface antigen can still test positive for anti-HBc. Therefore, a single positive anti-HBc is difficult to determine if the patient has a recent infection or a previous infection.

Detection of anti-HBcIgM and IgG is of great significance in the diagnosis of acute Hepatitis B. Acute Hepatitis B may have two scenarios: one is true acute Hepatitis B, which means the patient is infected with Hepatitis B virus for the first time; the other is that the patient is a surface antigen carrier and now has an acute episode, which seems similar to acute Hepatitis B on the surface. However, the levels of core antibodies in the blood of these two types of patients are different. In patients with chronic carriage and acute episode, the levels of anti-HBcIgG or anti-HBc in the serum are relatively high, while the levels of anti-HBcIgM are low or slightly high. In true acute Hepatitis B patients, the levels of anti-HBcIgG in the serum are often negative or low. Therefore, this test can help distinguish between these two scenarios.

Given that their prognoses are different, true acute Hepatitis B can often be completely cured, while chronic carriers with acute episodes often tend to develop chronic Hepatitis B. Therefore, it can be seen that the detection of anti-HBcIgM and IgG is crucial.