- Hepatitis B
- Tests & Interpretation
How do I interpret some of the common hepatitis B panel results?
| Table 2 | |||
| Tests | Results | Interpretation | Vaccinate? |
| HBsAg anti-HBc anti-HBs |
negative negative negative |
susceptible | vaccinate if indicated |
| HBsAg anti-HBc anti-HBs |
negative negative positive with >10mIU/mL* |
immune due to vaccination (or may represent passive transfer of antibodies from receipt of HBIG) | no vaccination necessary |
| HBsAg anti-HBc IgM anti-HBc anti-HBs |
negative positive negative positive |
immune due to natural infection | no vaccination necessary |
| HBsAg anti-HBc IgM anti-HBc anti-HBs |
negative positive positive positive |
acute resolving infection | no vaccination necessary |
| HBsAg anti-HBc IgM anti-HBc anti-HBs |
positive positive positive negative |
acutely infected | no vaccination necessary |
| HBsAg anti-HBc IgM anti-HBc anti-HBs |
positive positive negative negative |
chronically infected | no vaccination necessary (may need treatment) |
| HBsAg anti-HBc anti-HBs |
negative positive negative |
four interpretations possible† | use clinical judgment |
* Postvaccination testing, when it is recommended, should be performed 1-2 months after the last dose of vaccine. Infants born to HBsAg-positive mothers should be tested for HBsAg and anti-HBs after completion of at least 3 doses of a licensed hepatitis B vaccination series, at age 9-18 months (generally at the next well child visit).
†1. May be distantly immune, but the test may not be sensitive enough to detect a very low level of anti-HBs in serum
2. May be susceptible with a false positive anti-HBc
3. May be chronically infected and have an undetectable level of HBsAg present in the serum
4. Passive transfer of antibody following HBIG administration or from an HBsAg-positive mother to her newborn
Last reviewed:
July 21, 2023