Serologic Testing for the Diagnosis of Hepatitis B Virus (HBV) Infection

The antigens and antibodies associated with HBV infection include HBsAg (Australia antigen) and antibody to HBsAg (anti-HBs), hepatitis B core antigen (HBcAg) and antibody to HBcAg (anti-HBc), and hepatitis B e antigen (HBeAg) and antibody to HBeAg (anti-HBe). At least one serologic marker is present during the different phases of HBV infection.

Serologic markers for the different phases of acute and chronic hepatitis B virus infection

Acute HBV infection

HBsAg HBeAg IgM anti-HBc IgG anti-HBc Anti- HBs Anti- HBe HBV DNA Interpretation
+ + + +++ Early phase
+ + Window phase
+ + + ± Recovery phase


Chronic HBV infection

HBsAg HBeAg IgM anti-HBc IgG anti-HBc Anti- HBs Anti- HBe HBV DNA Interpretation
+ + + +++ Replicative phase
+ + + ± Low, nonreplicative phase
+ ± + + + Flare of chronic HBV
+ + + ++ Precore/core promoter mutants



Interpretation of the Hepatitis B Panel

Interpretation HBsAg anti-HBc anti-HBs IgM anti-HBc
Susceptible negative negative negative
Immune due to natural infection negative positive positive
Immune due to hepatitis B vaccination negative negative positive
Acutely infected positive positive negative positive
Chronically infected positive positive negative negative
Interpretation unclear; four possibilities:

  1. Resolved infection (most common)
  2. False-positive anti-HBc, thus susceptible
  3. “Low level” chronic infection
  4. Resolving acute infection
negative positive negative

Hepatitis B Profile




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Created: Nov 21, 2011.