Hepatitis B Serology Test Result Interpretation

 Hepatitis B serologic testing involves the measurement of hepatitis B virus (HBV) specific antigens and antibodies. Different serologic markers are used to identify different phases of Hepatitis B virus (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)  is the most important serological marker for identifying infection with hepatitis B virus.

HBsAg, for hepatitis B serology test, is present early in acute infection, disappears with a resolution of infection, and persists in chronic infection.

IgM anti-HBc (IgM class antibody, against hepatitis B core antigen) is essential for the diagnosis of acute infection but is also seen occasionally in very active chronic hepatitis. Anti-HBc antibodies develop and persist after all HBV infections.

The loss of HBsAg and development of anti-HBc signals resolution of acute infection.

Anti-HBs also occur post-vaccination, but anti-HBc will not be present in such cases. Chronic infection is manifested by persistent HBsAg.

Markers of viral replication such as HBeAg and HBV-DNA (non-PCR method) are detectable during the early high replication phase but are not detectable during the later quiescent low replication phase. HBeAg is not a reliable marker of HBV replication when a precore variant is responsible for the infection. Such cases will be HBeAg negative, anti-HBe positive, but HBV-DNA (by a non-PCR method) positive.

Hepatitis B surface antigen (HBsAg): A protein on the surface of hepatitis B virus, it can be detected for serology test 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.

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 undefined time frame.