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Difficulty: EasyInterpreting Laboratory Results

A 30-year-old healthcare worker is undergoing routine employee health screening. As part of a clinic educational review, various patient Hepatitis B serologic panels are evaluated. Match each of the following Hepatitis B laboratory serologic patterns to the most accurate diagnostic interpretation.

  • HBsAg (+), Anti-HBc IgM (+), Anti-HBs (-)Acute Hepatitis B infection
  • HBsAg (-), Anti-HBc IgG (+), Anti-HBs (+)Resolved prior Hepatitis B infection
  • HBsAg (-), Anti-HBc (-), Anti-HBs (+)Immunity secondary to Hepatitis B vaccination
  • HBsAg (+), Anti-HBc IgG (+), Anti-HBs (-)Chronic Hepatitis B infection

Answer

Pattern 1 matches Acute infection; Pattern 2 matches Resolved infection; Pattern 3 matches Vaccination immunity; Pattern 4 matches Chronic infection.
Each laboratory pattern uniquely identifies a distinct phase of Hepatitis B infection or immunity. Active infection is defined by the presence of HBsAg, which is further classified as acute (IgM Anti-HBc) or chronic (IgG Anti-HBc). Immunity is defined by the presence of Anti-HBs. Natural immunity features Anti-HBc IgG due to exposure to the whole virus, whereas vaccine-induced immunity lacks Anti-HBc entirely.

Step-by-Step Solution

1
Analyze the HBsAg status for each serologic pattern.
Patterns 1 and 4 are HBsAg positive, indicating active viral infection. Patterns 2 and 3 are HBsAg negative, indicating no active infection and potential immunity.
HBsAg (surface antigen) is the primary marker of active viral presence, whether acute or chronic.
2
Evaluate the Anti-HBc (core antibody) and Anti-HBs (surface antibody) status to finalize the interpretation.
Pattern 1 has IgM Anti-HBc (acute). Pattern 4 has IgG Anti-HBc (chronic). Pattern 2 has IgG Anti-HBc plus Anti-HBs (resolved natural infection). Pattern 3 has Anti-HBs but lacks Anti-HBc entirely (vaccination).
Core antibodies develop only after natural exposure to the complete virus. Recombinant vaccines only contain the surface antigen, producing isolated Anti-HBs.

Key Concept

Hepatitis B Serology Interpretation
Estimated Time:1m 0s
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Topics

Interpreting Laboratory Results

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