What does it mean if my Hepatitis B surface antigen (HbsAg) is non-reactive (NR), antibody to Hepatitis B surface antigen (Ab to HBsAg) is reactive (R), and antibody to Hepatitis C antigen (Ab to Hep C Ag) is non-reactive (NR)?

Interpretation of Hepatitis B and C Serology Results

Your test results indicate you have immunity to Hepatitis B from either past infection or vaccination, and you do not have Hepatitis C infection.

Understanding Your Results

• HBsAg: NR (Non-Reactive) - This means you do not have active hepatitis B virus infection 1
• Ab to HBsAg: R (Reactive) - This indicates you have antibodies to hepatitis B surface antigen, meaning you have immunity to hepatitis B 1, 2
• Ab to Hep C Ag: NR (Non-Reactive) - This shows you do not have antibodies to hepatitis C virus, meaning you do not have current or past hepatitis C infection 1

What This Means For You

Hepatitis B Status

• Your pattern of negative HBsAg with positive anti-HBs indicates immunity to hepatitis B 1, 2
• This immunity could be from:
  • Successful hepatitis B vaccination 1, 3
  • Recovery from a past hepatitis B infection 1, 2
• You are protected against future hepatitis B infection 4
• You are not infectious and cannot transmit hepatitis B to others 5

Hepatitis C Status

• Your negative hepatitis C antibody test indicates you have not been infected with hepatitis C virus 1

Additional Considerations

• If you received hepatitis B vaccination, your immunity is likely long-lasting, even if antibody levels decline over time 4
• If your immunity is from past infection, you may benefit from additional testing for hepatitis B core antibody (anti-HBc) to confirm this 2, 6
• For individuals with certain medical conditions (chronic liver disease, HIV infection, or those requiring immunosuppressive therapy), monitoring of hepatitis B status may be recommended 2, 7

When to Consider Further Testing or Vaccination

• If you are at ongoing risk for hepatitis B or C exposure (healthcare worker, injection drug use, multiple sexual partners), periodic testing may be recommended 1
• If you have chronic liver disease from other causes, vaccination against hepatitis A (if not already immune) may be recommended 7
• If you will be receiving immunosuppressive therapy, additional monitoring may be needed as there is a small risk of hepatitis B reactivation even in those with resolved infection 2

Common Pitfalls to Avoid

• Don't assume immunity is permanent - antibody levels may decline over time, though protection often remains 4
• Don't confuse immunity from vaccination with immunity from past infection - they have different implications for long-term health 2, 6
• Don't ignore the need for hepatitis A vaccination if you have other liver conditions 7