Interpretation of Hepatitis B Serological Results
A negative Hepatitis B Core Antibody IgM with a positive Total Hepatitis B Core Antibody (IgG+IgM) indicates resolved past hepatitis B infection with immunity. This serological pattern shows that you were infected with hepatitis B virus in the past but have recovered and now have natural immunity against reinfection 1.
Understanding Your Results
The serological pattern you have shows:
- Hepatitis B Core Antibody (IgM): Negative
- Hepatitis B Core Antibody Total (IgG+IgM): Positive
This specific pattern means:
- Your body has developed antibodies against the hepatitis B core antigen (anti-HBc)
- The absence of IgM class antibodies indicates this is not a recent or acute infection
- The presence of total antibodies (which includes IgG) indicates past exposure to the virus
- This pattern is consistent with resolved hepatitis B infection that occurred more than 6 months ago 2, 1
Clinical Significance
This result has several important implications:
- Immunity status: You have natural immunity to hepatitis B from prior infection 1
- Not infectious: You are not currently infected with hepatitis B and cannot transmit the virus to others
- No liver damage: This pattern alone does not suggest ongoing liver damage from hepatitis B
- Differentiation from vaccination: This pattern indicates natural immunity from infection rather than vaccine-induced immunity (which would show positive hepatitis B surface antibody but negative core antibody) 2
Additional Testing Considerations
To complete your hepatitis B profile, the following tests would be helpful if not already done:
- Hepatitis B Surface Antigen (HBsAg): Should be negative, confirming no active infection
- Hepatitis B Surface Antibody (anti-HBs): If positive, confirms protective immunity; if negative, may indicate waning immunity after past infection 1
Special Circumstances
Immunosuppression Risk
If you ever require immunosuppressive therapy (such as chemotherapy, biological agents, or high-dose steroids), be aware that:
- There is a small risk of hepatitis B reactivation even in patients with resolved infection
- You should inform healthcare providers about your hepatitis B history before starting immunosuppressive treatments
- Prophylactic antiviral therapy may be recommended during certain high-risk immunosuppressive treatments 1
Isolated Core Antibody
If additional testing shows you are negative for both HBsAg and anti-HBs (surface antibody), this would be called "isolated core antibody" which could represent:
- Resolved infection with waning surface antibody levels
- Low-level chronic infection with undetectable HBsAg
- False positive core antibody test
- Resolving acute infection 1
Practical Implications
- No specific treatment is needed for resolved hepatitis B infection
- No special monitoring is required for immunocompetent individuals with this serological pattern
- This finding should be documented in your medical record for future reference
- Consider hepatitis A vaccination if not already immune, as hepatitis A superinfection can increase morbidity in those with prior HBV exposure 1
This serological pattern is common and generally indicates a favorable outcome after natural infection with hepatitis B virus.