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    KEY BIOMARKER: HBeAg testing

    HBeAg indicates immune activity, helps define disease phase, and differentiates between active* and inactive chronic hepatitis B (CHB)1-3

    Who to Test

     

    BEFORE TREATMENT

    All newly diagnosed CHB patients:

    To determine immune-tolerant vs immune-active phase of infection2

     

    Pregnant women who are HBsAg+:

    To assess risk of vertical transmission2,4

    HBeAg testing before treatment table

    Who to Test

     

    DURING TREATMENT

    All patients: To monitor HBeAg seroconversion2

     

    AFTER TREATMENT

    Patients with suspected reactivation or liver flares2

    HBeAg testing during and after treatment table

    HBeAg and its association with long-term outcomes4-6

     

    HBeAg/ANTI-HBe SEROCONVERSION HAS BEEN ASSOCIATED WITH:
    Favorable
    prognosis    		 Lower incidence
    of cirrhosis    		 Lower incidence
    of HCC

    Earlier HBeAg seroconversion may also be associated with improved long-term outcomes.7

     

    In a long-term follow-up study (N=770), patients who experienced HBeAg seroconversion after age 40 had a higher risk of cirrhosis and HCC compared with those who seroconverted before age 30 (HR=17.6 [95% CI: 7.15–43.5; P<0.0001] and HR=5.22 [95% CI: 1.17–23.3; P=0.030], respectively).7

    * Per AASLD guidelines, immune-active CHB is defined by ALT ≥2X ULN or significant histologic disease with HBV DNA >2,000 IU/mL (HBeAg-negative) or >20,000 IU/mL (HBeAg-positive).2

     

    AASLD=American Association for the Study of Liver Diseases; ALT=alanine aminotransferase; anti-HBe=anti–hepatitis B e-antigen; CI=confidence interval; DNA=deoxyribonucleic acid; HBeAg+=hepatitis B e-antigen–positive; HBeAg-=hepatitis B e-antigen–negative; HBsAg+=hepatitis B surface antigen–positive; HBV=hepatitis B virus; HCC=hepatocellular carcinoma; HR=hazard ratio; ULN=upper limit of normal.

    Learn about HBV DNA as a biomarker

    EXPLORE HBV DNA

    References

    1. Understanding your test results. Hepatitis B Foundation. Accessed April 5, 2026. https://www.hepb.org/prevention-and-diagnosis/diagnosis/understanding-your-test-results/#:~:text=Understanding

    2. Terrault NA, et al. Hepatology. 2018;67(4):1560-1599.

    3. Wong GLH, Lemoine M. J Hepatol. 2025;82(5):918-925.

    4. European Association for the Study of the Liver. J Hepatol. 2025;83(2):502-583.

    5. Niederau C, et al. N Engl J Med. 1996;334(22):1422-1427.

    6. Lin CL, Kao JH. Clin Mol Hepatol. 2016;22(4):423-431.

    7. Chen YC, et al. Hepatology. 2010;51(2):435-444.