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Hepatitis B

Testing

Hepatitis B status can be determined using results of several commonly ordered tests.

HBsAg Anti-HBs Anti-HBc IgM Anti-HBc IgG Interpretation
+ - - -
  • early acute infection
  • patient is infectious; consider vaccination for susceptible household & sexual contacts
+ - + +
  • acute infection
  • patient is infectious; consider vaccination for susceptible household & sexual contacts
+ - - +
  • chronic infection
  • patient is infectious; patient should be evaluated for chronic liver disease; vaccinate susceptible household & sexual contacts
- + +/- +
  • resolved infection
  • patient is immune
- - + -
  • “window period” following acute infection
  • patient is not infectious
- - - +
  • false positive anti-HBc result

  • "window phase" of resolving acute infection

  • late immunity stage

  • unresolved infection in late or low grade state

  • patient is non-infectious in most settings (household, sexual, needle stick exposures)

- + - -
  • immune following vaccination; resolved infection with loss of detectable anti-HBc
  • patient is immune