Hepatitis B Serologic Pattern: Immunity from Vaccination
Your serologic pattern (HBsAg non-reactive, HBsAb reactive, HBcAb non-reactive) indicates immunity to hepatitis B virus from successful vaccination. 1, 2
What This Pattern Means
You are immune to hepatitis B infection through vaccination rather than natural infection, as confirmed by the presence of HBsAb without HBcAb. 1, 3
You are not currently infected with hepatitis B virus, as evidenced by the negative HBsAg. 1, 2
You cannot transmit hepatitis B to others because you have no active infection. 2
You have never had a natural hepatitis B infection, which is distinguished by the absence of HBcAb (core antibody). 3 The presence of HBsAb alone, without HBcAb, specifically indicates vaccine-derived immunity rather than immunity from past infection. 3
Clinical Significance
Protective immunity is confirmed when HBsAb levels are ≥10 mIU/mL, which is the threshold used by commercial assays to indicate protection. 3
No treatment or vaccination is needed because you already have protective immunity. 1, 2
This immunity is durable due to immunologic memory that persists even if antibody levels decline over time. 4 Studies demonstrate that vaccine-induced memory B lymphocytes continue to provide protection for 5-12 years or longer, even when antibody levels fall below detectable thresholds. 4
Special Considerations for Immunosuppression
If you require immunosuppressive therapy (such as chemotherapy, anti-CD20 monoclonal antibodies like rituximab, or high-dose corticosteroids), you should be monitored for potential loss of immunity. 1, 2
HBV reactivation risk is minimal in your case because you lack HBcAb, meaning you have no prior natural infection that could reactivate. 1, 5 The 3-45% reactivation risk applies specifically to patients who are HBcAb-positive, not to those with vaccine-derived immunity alone. 1, 3
Routine booster vaccination is not recommended for healthy individuals with vaccine-derived immunity, as immunologic memory provides ongoing protection independent of measurable antibody levels. 4
When Additional Testing May Be Needed
Periodic monitoring of HBsAb levels may be considered if you are a healthcare worker or have ongoing high-risk exposures to hepatitis B. 2
Postvaccination testing would have been indicated if you had chronic liver disease or advanced immunosuppression at the time of vaccination, due to lower seroconversion rates in these populations. 6