HbeAg status makes me puzzled

Hello everyone,

I’ve been managing chronic hepatitis B and would like to understand more about my recent test results and what they might indicate. Here’s a brief overview of my situation:

•	Two years ago, my test results were:
•	HBsAg: Positive
•	HBeAg: Positive
•	Anti-HBe: Negative
•	Today, and for the past few months with tests repeated every two months, my results are:
•	HBsAg: Positive
•	HBeAg: Negative
•	Anti-HBe: Negative

The shift from HBeAg positive to negative, without the development of anti-HBe antibodies, has me puzzled. I understand that typically, anti-HBe should appear after HBeAg turns negative, indicating a possible resolution phase of the infection or at least a reduction in viral replication. However, in my case, the anti-HBe remains negative.

I’m interested in hearing if anyone else has experienced a similar pattern and what potential implications this could have for my health or treatment options.

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Perhaps HBV has stopped replicating therefore no anti-HBe. Anti-HBe appears when there is HBeAG. I think the test results depends on timing or your current stage of the HBV infection and it’s accuracy. Are you on antiviral medication? My understanding is chronic HBV level with antiviral the viral load fluctuates.

HBV is still there because HBsAg remains positive. You are correct that anti-HBe occurs after HBeAg turns negative; However, this might take some time. Sometimes this could last for years. You are likely at a transition stage between HBe positive/anti-HBe negative to HBeAg negative /anti-HBe positive. Please be aware that HBeAg can revert to positivity, so if you are on antiviral, keep taking it.

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Yes I’m on vemlidy which is easier on kidneys so Hep b resurfaced after 20 years about 4 years ago and now has damaged my kidneys and now those are functioning at %40 and have been told that nothing can be done until I get liver cancer. Just monitor for now. If that does happen then the anti rejection medication will kill what’s left of my kidneys. So one question is do you know any research that has been done on how hepatitis B affects the other organs besides the liver. It took me 4 years to get different doctors to work together

Thank you
LeeAnn

Hello LeeAnn
You say you are now on vemildy medication. Which HBV antiviral medication were you on prior to this? You said HBV resurfaced few years ago. I am guessing HBV was inactive with low to undetectable vital load for the 20 years with chronic HBV and no daily regiment of antiviral was recommended by your doctor?

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Thank you for the reply. Yes I’m on antiviral from 2012 Tenofovir, and moved from 2019 till present to Vemlidy.

HbsAg Quantitative has been reduced also over the years, this year was around 2000, and in 2012 it was at around 50k.

Then if I understand right the appearance of antiHbeAg could take even years to appear. The doctor said the same - to be sure that this is something stable the HbeAg needs to remain negative for more than 6 months and antiHbeAg to appear, and to stay like that for more than 6 months.