HBV Serology: First Principles and Pattern Interpretation
Authors: Sean Spence, Kelly Burak* Reviewers: Crystal Liu, Kara Hawker, Dean Percy, Yan Yu, Sam Lee* * MD at time of initial publication
HBsAg
HBV Core antigen
Marker of HepB infection at some point
Anti-HBsAg
Denotes immunity
HBeAg
Anti-HBeAg
Presence denotes current HBV infection (chronic or acute)
Anti-HBcAg IgM acute/recent infection
Anti-HBcAg IgG chronic/remote infection
(Due to vaccination or past exposure)
Marker of active viral disease and patient infectiousness
Detected in chronically infected patients or patients who have cleared infection
Never infected, never immunized
–
–
–
–
–
–
Chronic infection/carrier
+
+/-
+
–
+/-
+/-
Acute infection
+
+
–
–
+
–
Natural immunity (past infection)
–
–
+
+
–
+/-
Immunized
–
–
–
+
–
–
Historical Notes:
• HBeAg was previously used as a marker of viral replication
• Presence of Anti-HBeAg antibodies indicates that the antigen has been
cleared, representing seroconversion and a halt to viral replication
• HBV DNA is the current clinical marker of viral replication, and can be
used to assess viral load in the body
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Re-Published May 5, 2019 on www.thecalgaryguide.com