Interpreting the Hepatitis B Panel
|
Test Panel |
|
| HBsAg | Hepatitis B Surface Antigen |
| anti-HBc | Hepatitis B Core Antibody (IgG and/or IgM) |
| anti-HBs | Hepatitis B Surface Antibody |
| IgM anti-HBc | Hepatitis B Core Antibody (IgM; a subclass of anti-HBc) |
| Tests | Results | Interpretation |
| HBsAg anti-HBc anti-HBs |
negative negative negative |
Susceptible |
| HBsAg anti-HBc anti-HBs |
negative negative positive with > 10mIU/mL* |
Immune
due to vaccination *Note: Post-vaccination testing, when recommended, should be done one to two months following dose #3 |
| HBsAg anti-HBc anti-HBs |
negative positive positive |
Immune due to natural infection |
| 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, The person might be: 1. Recovering from acute HBV infection (Window phase) 2. Distantly immune from previous HBV infection and the test is not sensitive enough to detect a very low level of anti-HBs 3. Susceptible to infection, false positive anti-HBc 4. Chronically infected, but with undetectable levels of HBsAg |
Sources:
CDC Interpretation of Hepatitis B Panel available at http://www.cdc.gov/ncidod/diseases/hepatitis/b/Bserology.htm.
Lok, A. Serologic diagnosis of hepatitis B virus infection. UpToDate version 14.1 (last updated May, 2005).