Hep B Core Ab, Tot [aka Total antibody to hepatitis B core antigen (anti-HBc)] appears at the onset of symptoms in acute hepatitis B, is a measure of both IgM and IgG, and persists for life. The presence of total anti-HBc indicates previous or ongoing infection with hepatitis B virus in an undefined time frame. People who have immunity to hepatitis B from a vaccine do not develop anti-HBc.
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Hepatitis B serologic testing involves measurement of several hepatitis B virus (HBV)-specific antigens and antibodies. Different serologic “markers” or combinations of markers are used to identify different phases of 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):
A protein on the surface of hepatitis B virus that can be detected in high levels in serum during acute or chronic hepatitis B virus infection. The presence of HBsAg indicates that the person is infectious, except when it might be transiently positive within 30 days after a dose of hepatitis B vaccine (HepB). The body normally produces antibodies to HBsAg as part of the normal immune response to infection. HBsAg is the antigen used to make HepB vaccine.
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. Among vaccine responders who completed a vaccine series, anti-HBs levels can decline over time, however the majority are still immune and will mount a response when exposed to HBV.
Total antibody to hepatitis B core antigen (anti-HBc):
Appears at the onset of symptoms in acute hepatitis B, is a measure of both IgM and IgG, and persists for life. The presence of total anti-HBc indicates previous or ongoing infection with hepatitis B virus in an undefined time frame. People who have immunity to hepatitis B from a vaccine do not develop anti-HBc.
IgM antibody to hepatitis B core antigen (IgM anti-HBc):
Positivity indicates recent infection with hepatitis B virus (<6 mos). Its presence indicates acute infection. IgM anti-HBc should be ordered only when acute HBV infection is a concern.
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| Test and Result | Interpretation | Action |
|---|---|---|
| HBsAg—Positive Total anti-HBc — Positive IgM anti-HBc — Positive Anti-HBs — Negative |
Acute infection | Link to hepatitis B care |
| HBsAg — Positive Total anti-HBc — Positive IgM anti-HBc — Negative1 Anti-HBs — Negative |
Chronic Infection | Link to hepatitis B care |
| HBsAg — Negative Total anti-HBc — Positive Anti-HBs — Positive |
Resolved Infection | Counsel about HBV infection reactivation risk |
| HBsAg — Negative Total anti-HBc — Negative Anti-HBs — Positive2 |
Immune from receipt of prior vaccination (if documented complete series) | If no documentation of full vaccination, then complete vaccine series per ACIP recommendations. |
| HBsAg — Negative Total anti-HBc — Positive Anti-HBs — Negative |
Only core antibody is positive. See possible interpretations and corresponding actions: | |
| Resolved infection where anti-HBs levels have waned | Counsel about HBV infection reactivation risk | |
| Occult Infection | Link to hepatitis B care | |
| Passive transfer of anti-HBc to an infant born to an HBsAg-positive gestational parent | No action | |
| A false positive, thus patient is susceptible | Offer HepB vaccine per Advisory Committee on Immunization Practices (ACIP) | |
| A mutant HBsAg strain that is not detectable by laboratory assay | Link to hepatitis B care | |
| HBsAg — Negative Total anti-HBc — Negative Anti-HBs — Negative3 |
Susceptible, never infected (if no documentation of HepB vaccine series completion) | Offer HepB vaccine per ACIP recommendations |
1 IgM anti-HBc also might be positive in persons with chronic infection during severe HBV infection flares or reactivation.
2 Immune if anti-HBs concentration is >10 mIU/mL after vaccine series completion.
3 Anti-HBs concentrations might wane over time among vaccine responders. People with a documented, complete HepB vaccine series typically do not need to be revaccinated, except for special populations like patients on hemodialysis or health care personnel.
References:
https://www.cdc.gov/hepatitis/hbv/interpretationOfHepBSerologicResults.htm
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You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we do talk about popular labs, we welcome reports from lots of other places too. It's as simple as this: if you can get a test done, you can upload it to Healthmatters. We can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
Still on the hunt for a specific biomarker? Just tell us, and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account!
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Yes, you can download information from your account. We can compile your labs into a CSV file. To download all your labs, you can go to Account Settings, and at the bottom of the page, you will find a link to download your information.
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Anaplasma phagocytophIlum Antibodies IFA Titre (IgG), Beta-2 Microglobulin, Serum, Brucella spp by Agglutination, Flavivirus IgG EIA, HBsAg Screen, HCV Antibody RFX to Quant PCR, HCV RNA, Quantitative Real Time PCR, Hep A Ab, IgM, Hep A Ab, Total, Hep B Core Ab, IgM, Hep B Core Ab, Tot, Hep B Surface Ab, Qual, Hep C Virus Ab, Hepatitis A Virus Antibody, Hepatitis B Core Antibody (Total), Hepatitis B Surf Ab Quant, Hepatitis B Surface Antibody, Hepatitis B Surface Antibody, Qualitative, Hepatitis B Surface Antigen (HBsAg Screen), Hepatitis C Virus Antibody, HIV Ab/p24 Ag with Reflex, HIV-1/HIV-2 Antibodies -EIA, HSV Type 1-Specific Ab, IgG, HSV-2 Ab, IgG, Murine typhus IgG by IFA, Q Fever P1 IgG FA, Q Fever P1 IgM FA, Q Fever P2 IgG FA, Q Fever P2 IgM FA, Rapid plasma reagin (RPR), RMSF IgG by IFA, RPR (DX) W/Refl Titer and Confirmatory Non-Reactive Testing, RPR, Rfx Qn RPR/Confirm TP, Syphilis Scrn w/rflx RPR and Titer, or TPPA, Treponema Palladium Total Antibodies (FTA abs), VDRL, West Nile Virus AB (IgG), Serum, West Nile Virus IgM EIA
