Interpreting Hepatitis B Tests

alt

The following table from the U.S. Centers for Disease Control and Prevention (CDC) provides interpretations for Hepatitis B serologic markers. A PDF version is also available.

 

Interpretation of Hepatitis B Serologic Test Results

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

Interpretation unclear; four possibilities:

1.

Resolved infection (most common)

2.

False-positive anti-HBc, thus susceptible

3.

"Low level" chronic infection

4.

Resolving acute infection

 

Hepatitis B surface antigen (HBsAg):A protein on the surface of HBV; it can be detected in high levels in serum during acute or chronic HBV 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 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 HBV in an undefined time frame.

IgM antibody to Hepatitis B core antigen (IgM anti-HBc):Positivity indicates recent infection with HBV (≤6 months). Its presence indicates acute infection.

 

 

What are antigens and antibodies?

An antigen is a substance on the surface of a virus that causes a person's immune system to recognize and respond to it. When the body is exposed to an antigen, the body views it as foreign material and takes steps to neutralize the antigen by producing antibodies. An antibody is a substance found in the blood that the body produces in response to a virus. Antibodies protect the body from disease by attaching to the virus and destroying it.

What are the common blood tests available to diagnose Hepatitis B?

There are many different blood tests available to diagnose Hepatitis B. They can be ordered as an individual test or as a series of tests. Ask your health professional to explain what he or she hopes to learn from the tests and when you will get the results.

Page last updated June 18, 2010.

Source

CDC Hepatitis B FAQs (frequently asked questions) for the Public, available at www.cdc.gov/hepatitis/B/bFAQ.htm. Chart adapted 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).