In patients with chronic hepatitis B, what does the presence of HBeAg indicate?

The presence of HBeAg in patients with chronic hepatitis B is an indicator of viral replication and high infectiousness. HBeAg is a protein secreted by the hepatitis B virus (HBV) during active replication and signifies that the virus is actively multiplying in the host. This often correlates with elevated levels of HBV DNA in the blood, meaning that the individual is more likely to transmit the virus to others.

Additionally, HBeAg positivity typically suggests that the patient is in an active phase of hepatitis B infection, which can lead to liver inflammation and a higher risk for complications such as cirrhosis and hepatocellular carcinoma over time. Therefore, in clinical practice, detecting HBeAg is crucial in determining the infectious status of patients with chronic hepatitis B and guiding further management.

The other options do not accurately describe the implications of HBeAg. Non-replicative states are associated with the absence of HBeAg, while a chronic infection without risk would imply low HBV replication, which is not the case when HBeAg is present. Resolved infection would mean the absence of detectable viral markers, which is also inconsistent with positive HBeAg.