Interpretation of Hepatitis B Serologic Test ResultsHepatitis 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 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 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. TestsResultsInterpretationHBsAgnegativeS usceptibleanti-HBcnegativeanti-HBsnegati veHBsAgnegativeImmune due to natural infectionanti-HBcpositiveanti-HBspositiv eHBsAgnegativeImmune due to hepatitis B vaccinationanti-HBcnegativeanti-HBsposit iveHBsAgpositiveAcutely infectedanti-HBcpositiveIgM anti-HBcpositiveanti-HBsnegativeHBsAgpos itiveChronically infectedanti-HBcpositiveIgM anti-HBcnegativeanti-HBsnegativeHBsAgneg ativeInterpretation unclear; four possibilities:anti-HBcpositive1. Resolved infection (most common)anti-HBsnegative2. False-positive anti-HBc, thus susceptible3. Low level chronic infection4. Resolving acute infectionAdapted from: A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. Part I: Immunization of Infants, Children, and Adolescents. MMWR 2005;54(No. RR-16).DEPARTMENT OF HEALTH & HUMAN SERVICESCenters for Disease Control and PreventionDivision of Viral
Interpretation of Hepatitis B Serologic Test Results
Interpretation of Hepatitis B Serologic Test Results Hepatitis B serologic testing involves measurement of several hepatitis B virus (HBV)-speciﬁ c antigens and ...
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