All-positive HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in a patient with hepatitis B: A case report.

RATIONALE

Mass vaccination, low cost of immunoglobulins, and new drugs led to the emergence of new, unusual patterns of hepatitis B serum markers. This study reported a rare case of hepatitis B with all 5 positive serum markers, including HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb.

PATIENT CONCERNS

A 30-year-old female patient was admitted due to abnormal liver function. The 5 serum markers were all positive (+), including HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb. After antiviral therapy, she was discharged with normal liver function and decreased hepatitis B virus-DNA levels, but all 5 serum markers were still positive. Regular follow-up was conducted every 3 months.

DIAGNOSES

Abnormal liver function.

INTERVENTIONS

The patient received antiviral treatment and liver protection therapy using entecavir dispersive tablet 0.5 mg po qd and glycyrrhizate diamine enteric capsule 150 mg po tid.

OUTCOMES

The patient's liver function was normal, hepatitis B virus-DNA continued to decline, and HBeAb turned negative at 6 months. After 9 and 12 months of follow-up, the results of hepatitis B markers in the patient were stable in HBsAg positive (+), HBeAb positive (+), and HBcAb positive (+).

LESSONS

The rare pattern of all 5 positive hepatitis B markers may occur in patients with chronic hepatitis B. Improvements can be achieved using first-line drugs and conventional treatment. Nevertheless, more attention should be paid to the patient's condition.