Five Stages in Hepatitis B Viral Infection

(Correlated with the level of antigen and antibody)

S. Saengamnatdej, Ph.D.

Stages Features Period after Level of antigen

the exposure and antibody
(months)
I Incubation 0-2 HbsAg
- 1-5 months with the peak around 3rd month
II Acute disease 2-5 HbsAg
- Acute symptoms - in non-carriers, as in stage I and undetectable at
- Raised serum the end of this stage.
transaminases (LFT: - in carriers, the HBsAg levels off from the peak.
increased) HBeAg
- 2-4 months, peak around 3rd month
HBcAb
(started off from the 2nd month onwards)
III Window period 5-6 No HBsAg
No HBsAb
HBeAb begins to rise.
IV Convalescence 6-9 HBsAb started and reached its peak before the
end of this stage.
V Recovered, or 9th month Antibodies against HBcAg, HBsAg, and HBeAg
Chronic infection onwards can be found.
- No clinical In the case of carriers, HBsAg also appears
symptoms (Detection of HBsAg after 6 months of exposure
is considered a chronic infection and the patient
is a carrier.)

Reference
Spicer, W.J. Viral Hepatitis. Clinical Microbiology and Infectious Diseases. Churchill
Livingstone, Elsevier, 2008, 2nd edition, pp.170-172.