Hepatitis B Serology
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Interpretation of the Hepatitis B Panel

Tests Results  Interpretation
HBsAg
anti-HBc
anti-HBs
negative
negative
negative
   
Susceptible
  
HBsAg
anti-HBc
anti-HBs
negative
positive
positive
  
 Immune due to natural infection
   
HBsAg
anti-HBc
anti-HBs
negative
negative
positive
Immune due to hepatitis B vaccination**
HBsAg
anti-HBc
IgM anti-HBc
anti-HBs
positive
positive
positive
negative
  
Acutely
infected
  
HBsAg
anti-HBc
IgM anti-HBc
anti-HBs
positive
positive
negative
negative
   
Chronically
infected
   
HBsAg
anti-HBc
anti-HBs
negative
positive
negative
Four
interpretations
possible *
* Four Interpretations:
  1. Might be recovering from acute HBV infection.
  2. Might be distantly immune and test not sensitive enough to detect very low level of anti-HBs in serum.
  3. Might be susceptible with a false positive anti-HBc.
  4. Might be undetectable level of HBsAg present in the serum and the person is actually chronically infected.

** Antibody response (anti-HBs) can be measured quantitatively or qualitatively. A protective antibody response is reported quantitatively as 10 or more milliinternational units (>=10mIU/mL) or qualitatively as positive. Post-vaccination testing should be completed 1-2 months after the third vaccine dose for results to be meaningful.

Definitions

  • Hepatitis B Surface Antigen (HBsAg): A serologic marker on the surface of HBV. It can be detected in high levels in serum during acute or chronic hepatitis. The presence of HBsAg indicates that the person is infectious. The body normally produces antibodies to HBsAg as part of the normal immune response to infection.
  • Hepatitis B Surface Antibody (anti-HBs): The presence of anti-HBs is generally interpreted as indicating recovery and immunity from HBV infection. Anti-HBs also develops in a person who has been successfully vaccinated against hepatitis B.
  • Total Hepatitis B Core Antibody (anti-HBc): Appears at the onset of symptoms in acute hepatitis B and persists for life. The presence of anti-HBc indicates previous or ongoing infection with hepatitis B virus (HBV) in an undefined time frame.
  • IgM Antibody to Hepatits B Core Antigen (IgM anti-HBc): This antibody appears during acute or recent HBV infection and is present for about 6 months

Source: http://www.cdc.gov/ncidod/diseases/hepatitis/b/Bserology.htm

 

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