detection of mediterranean hepatitis b in a 45 years old man in mahdieh clinical laboratory, isfahan, iran

Three major hepatitis b virus (hbv) antigens include hbcag, hbeag and hbsag. hbeag is the extracellular form of hbcag, and is seen almost exclusively in people who have circulating serum hbv dna. presence of hbsag in serum indicates that the individual has contracted hbv infection. chronic hepatitis hbeag-negative/anti-hbe–positive is known as an important form of chronic hepatitis b in the mediterranean region. in this report, we used real-time pcr and elisa for detection of hbv and hbeag/hbsag, respectively. in our investigation on 4243 hbv cases referred to the mahdieh clinical laboratory between 2008 and 2016, we found a 53-year-old man with clinical symptoms of hepatitis and abnormal molecular and serological features. despite the presence of clinical symptoms and high viral load (128 × 10^5 iu/ml), the patient was hbsag-positive and hbeag-negative. identifying this type of hbv could indicate spread of this type of hepatitis in isfahan, iran.