. "5 Viral Hepatitis Services." Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. Washington, DC: The National Academies Press, 2010.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
TABLE 5-2 Interpretation of Hepatitis B Serologic Diagnostic Test Results
Antigen or Antibody Test
Result
Interpretation
HBsAg
Anti-HBc
Anti-HBs
All negative
Susceptible
HBsAg
Anti-HBc
Anti-HBs
Negative
Positive
Positive
Immune because of natural infection
HBsAg
Anti-HBc
Anti-HBs
Negative
Negative
Positive
Immune because of hepatitis B vaccination
HBsAg
Anti-HBc
IgM anti-HBc
Anti-HBs
Positive
Positive
Positive
Negative
Acutely infected
HBsAg
Anti-HBc
IgM anti-HBc
Anti-HBs
Positive
Positive
Negative
Negative
Chronically infected
HBsAg
Anti-HBc
Anti-HBs
Negative
Positive
Negative
Interpretation unclear; could be due to
Resolved infection
False-positive anti-HBc test
Low-level chronic infection
Resolving acute infection
Abbreviations: HBsAg, hepatitis B surface antigen; anti-HBc, total hepatitis B core antibody; anti-HBs, hepatitis B surface antibody; IgM anti-HBc, IgM antibody to hepatitis B core antigen.
SOURCE: CDC, 2009c.
Clinicians also may not know which tests to order to test for chronic vs acute viral HBV infection. Table 5-2 provides guidance on the interpretation of hepatitis B serologic test results.
Cost-effectiveness data on the use of laboratory testing in particular at-risk populations are available. As mentioned above, people born in foreign countries that have high rates of HBV (2% or more) are at the highest risk for chronic HBV infection and constitute the largest pool of undiagnosed persons (see Box 3-1). Laboratory testing of adult Asian and Pacific Islanders for HBV infection (10% prevalence of chronic HBV infection), monitoring and treating people who are found to be chronically infected, and
