[PDF] Interpretation of Hepatitis B Serologic Test Results



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Interpretation of Hepatitis B Serologic Test Results Hepatitis B serologic testing involves measurement of several hepatitis B virus (HBV)-specifi c antigens and antibodies. Different serologic “markers" or combinations of markers are used to identify different phases of HBV infection and to determine whether a patient has acute or chronic HBV infection, is immune to HBV as a result of prior infection or vaccination, or

is susceptible to infection.Hepatitis B surface antigen (HBsAg): A protein on the surface of hepatitis B virus; it can be detected in high levels in serum during acute or chronic hepatitis B virus infection. 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. HBsAg is the antigen used to make hepatitis B vaccine.

Hepatitis B surface

antibody (anti-HBs):

The presence of anti-HBs

is generally interpreted as indicating recovery and immunity from hepatitis B virus 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 in an undefi ned time frame.

IgM antibody to hepatitis B

core antigen (IgM anti-HBc):

Positivity indicates recent

infection with hepatitis B virus ( <6 mos). Its presence indicates acute infection.

TestsResults Interpretation

HBsAgnegative Susceptible

anti-HBc negative anti-HBs negative HBsAg negative Immune due to natural infection anti-HBc positive anti-HBs positive HBsAg negative Immune due to hepatitis B vaccination anti-HBc negative anti-HBs positive HBsAg positive Acutely infected anti-HBc positive

IgM anti-HBc

positive anti-HBs negative HBsAg positive Chronically infected anti-HBc positive

IgM anti-HBc

negative anti-HBs negative HBsAg negative Interpretation unclear; four possibilities: anti-HBc positive1. Resolved infection (most common) anti-HBs

negative2. False-positive anti-HBc, thus susceptible3. “Low level" chronic infection4. Resolving acute infection

Adapted from:

A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Com mittee on Immunization Practices. Part I: Immunization of Infants, Children, and Adolescents. MMWR 2005;54(No. RR-16).

DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

Division of Viral Hepatitis

www.cdc.gov/hepatitis CDC has revised this document. Please visit Interpretation of Hepatitis B Serologic Test Results | CDC found on the Division of Viral Hepatitis Website.

Revised Version Available

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