Interpretation of the hepatitis B serologic panel

Tests	Results	Interpretation
HBsAg	Negative	Susceptible
anti-HBc	Negative
anti-HBs	Negative
HBsAg	Negative	Prior infection (inactive)
anti-HBc	Positive
anti-HBs	Positive
HBsAg	Negative	Immune due to hepatitis B vaccination*
anti-HBc	Negative
anti-HBs	Positive
HBsAg	Positive	Acutely infected
anti-HBc	Positive
IgM anti-HBc	Positive
anti-HBs	Negative
HBsAg	Positive	Chronically infected
anti-HBc	Positive
IgM anti-HBc	Negative
anti-HBs	Negative
HBsAg	Negative	Four interpretations possible^¶
anti-HBc	Positive
anti-HBs	Negative

HBsAg: hepatitis B surface antigen; anti-HBc: hepatitis B core antibody; anti-HBs: hepatitis B surface antibody; IgM: immunoglobulin M; HBV: hepatitis B virus.

* Antibody response (anti-HBs) can be measured quantitatively or qualitatively. A protective antibody response is reported quantitatively as 10 or more milli-international units (≥10 mIU/mL) or qualitatively as positive. Postvaccination testing should be completed one to two months after the third vaccine dose for results to be meaningful.

¶ Four interpretations:

Might be recovering from acute HBV infection.
Might have had prior infection and test not sensitive enough to detect very low level of anti-HBs in serum.
Might be susceptible with a false positive anti-HBc.
Might be undetectable level of HBsAg present in the serum, and the person is actually chronically infected.

Centers for Disease Control and Prevention, Hepatitis B information for health professionals: Interpretation of hepatitis B serologic test results. Available from the CDC website.

Graphic 60827 Version 7.0

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Interpretation of the hepatitis B serologic panel