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Difficulty: MediumGastroenterology and Hepatology

Match the following Hepatitis B viral (HBV) serologic test profiles with their most accurate clinical interpretation. Assume all positive or negative results are definitive.

  • HBsAg (+), Anti-HBs (-), Anti-HBc IgM (+), Anti-HBc IgG (-)Acute Hepatitis B infection
  • HBsAg (+), Anti-HBs (-), Anti-HBc IgM (-), Anti-HBc IgG (+)Chronic Hepatitis B infection
  • HBsAg (-), Anti-HBs (+), Anti-HBc IgM (-), Anti-HBc IgG (+)Resolved Hepatitis B infection (natural immunity)
  • HBsAg (-), Anti-HBs (+), Anti-HBc IgM (-), Anti-HBc IgG (-)Immunity due to Hepatitis B vaccination
  • HBsAg (-), Anti-HBs (-), Anti-HBc IgM (+), Anti-HBc IgG (-)Acute Hepatitis B window period

Answer

The profiles correctly map as follows: Profile 1 is acute infection, Profile 2 is chronic infection, Profile 3 is resolved natural infection, Profile 4 is immunity from vaccination, and Profile 5 is the window period.
Each serologic marker provides distinct clinical information: HBsAg confirms the physical presence of the virus, Anti-HBs indicates systemic immunity (either cleared virus or successful vaccination), and Anti-HBc points strictly to natural viral exposure. The IgM isotype denotes recent or acute exposure, while IgG denotes past or chronic exposure.

Step-by-Step Solution

1
Evaluate HBsAg and Anti-HBs status for all profiles.
HBsAg(+) indicates active virus presence; HBsAg(-) with Anti-HBs(+) indicates immunity.
This primary step distinguishes between patients who are currently infected and those who are immune or susceptible.
2
Evaluate Anti-HBc status in the profiles with Anti-HBs(+).
Anti-HBc IgG(+) means natural immunity; Anti-HBc(-) means vaccine-induced immunity.
The vaccine contains only recombinant HBsAg, so vaccinated individuals never develop antibodies against the core antigen (HBcAg).
3
Evaluate Anti-HBc IgM vs. IgG in profiles with active infection (HBsAg+) or isolated core antibody.
IgM(+) indicates acute infection or the window period; IgG(+) indicates chronic infection.
IgM is the body's initial immune response to the core antigen, transitioning to IgG over several months.

Key Concept

Interpretation of Hepatitis B virus (HBV) serologic markers
Estimated Time:1m 30s
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Topics

Gastroenterology and Hepatology

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