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Difficulty: MediumGastroenterology and Hepatology

Match each patient's hepatitis B (HBV) serology profile with the most appropriate clinical diagnosis.

  • HBsAg negative, Anti-HBs positive, Anti-HBc (total) positiveResolved past HBV infection
  • HBsAg positive, HBeAg positive, Anti-HBc IgM positive, Anti-HBs negativeAcute HBV infection
  • HBsAg negative, Anti-HBs positive, Anti-HBc (total) negativeImmunity due to HBV vaccination
  • HBsAg positive, Anti-HBc IgG positive, Anti-HBe positive, persistently normal ALTInactive chronic HBV carrier

Answer

Profile 1 matches Resolved past HBV infection. Profile 2 matches Acute HBV infection. Profile 3 matches Immunity due to HBV vaccination. Profile 4 matches Inactive chronic HBV carrier.
Accurate interpretation of HBV serology relies on evaluating HBsAg (active infection vs. immunity), Anti-HBc (natural exposure vs. vaccination), and HBeAg/Anti-HBe status (infectivity and replication). The matched pairs correctly align these serological principles with their respective clinical phases.

Step-by-Step Solution

1
Analyze the HBsAg status for each profile.
Profiles 2 and 4 are HBsAg positive (active infection). Profiles 1 and 3 are HBsAg negative (no active infection).
HBsAg is the hallmark of active viral presence, distinguishing active disease from immunity or past infection.
2
Differentiate the HBsAg positive profiles (2 and 4).
Profile 2 has Anti-HBc IgM, indicating acute infection. Profile 4 has Anti-HBc IgG and Anti-HBe with normal ALT, indicating an inactive chronic carrier.
IgM antibodies represent acute or recent exposure, while IgG represents chronic or remote exposure.
3
Differentiate the HBsAg negative profiles (1 and 3).
Profile 1 has Anti-HBc (total) positive, indicating natural exposure and resolved infection. Profile 3 has Anti-HBc negative, indicating immunity from vaccination.
The HBV vaccine contains only HBsAg; therefore, vaccinated individuals will only develop Anti-HBs. Natural infection exposes the immune system to all viral proteins, leading to Anti-HBc production.

Key Concept

Interpretation of Hepatitis B virus (HBV) serological markers for disease staging
Estimated Time:1m 0s
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Topics

Gastroenterology and Hepatology

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