An infectious disease specialist is reviewing the laboratory data of five adult patients referred to an ambulatory clinic for evaluation of potential liver disease. Vital signs are within normal limits for all patients. Reference ranges for the hepatic panel are as follows: AST U/L, ALT U/L, Total Bilirubin mg/dL. Match each patient's comprehensive biochemical and serological laboratory profile to the most accurate diagnostic interpretation.
- Profile A: AST U/L, ALT U/L. Serology: HBsAg (-), Anti-HBs (+), Total Anti-HBc (-), Anti-HBc IgM (-)Immunity mediated by isolated surface antibody production (Vaccination)
- Profile B: AST U/L, ALT U/L. Serology: HBsAg (-), Anti-HBs (+), Total Anti-HBc (+), Anti-HBc IgM (-)Immunity with cleared viral load following natural exposure (Resolved infection)
- Profile C: AST U/L, ALT U/L, Total Bilirubin mg/dL. Serology: HBsAg (+), Anti-HBs (-), Total Anti-HBc (+), Anti-HBc IgM (+)Active viral replication with robust acute hepatocellular injury (Acute infection)
- Profile D: AST U/L, ALT U/L, Total Bilirubin mg/dL. Serology: HBsAg (-), Anti-HBs (-), Total Anti-HBc (+), Anti-HBc IgM (+)Core-antibody dominant phase following surface antigen clearance (Window period)
- Profile E: AST U/L, ALT U/L, Total Bilirubin mg/dL. Serology: HBsAg (+), Anti-HBs (-), Total Anti-HBc (+), Anti-HBc IgM (-)Persistent viral presence with mild ongoing hepatocellular inflammation (Chronic infection)
Cevap
Profile A matches Vaccination; Profile B matches Resolved infection; Profile C matches Acute infection; Profile D matches the Window period; Profile E matches Chronic infection.
Each laboratory profile distinctly maps to a specific phase of Hepatitis B immunity or infection, driven by the presence or absence of specific surface and core antigens/antibodies over time, corroborated by the degree of hepatocellular injury (transaminase levels).
Adım Adım Çözüm
Anahtar Kavram
Hepatitis B Serology Interpretation