Hepatitis B Surface Antibody Reactive: Immunity Confirmed
Your reactive Hepatitis B surface antibody (HBsAb) with non-reactive HBsAg and non-reactive HBcAb indicates you are immune to Hepatitis B virus through successful vaccination. 1, 2, 3
What Your Results Mean
Your serologic pattern demonstrates vaccine-derived immunity:
- HBsAg non-reactive: You do not have active Hepatitis B infection 1
- HBsAb reactive: You have protective antibodies against Hepatitis B 1, 2
- HBcAb non-reactive: You have never been naturally infected with Hepatitis B virus 1, 3
This specific combination confirms immunity acquired through vaccination rather than natural infection. 2, 3
Clinical Implications
You are protected against Hepatitis B infection and cannot transmit the virus to others. 2, 3
No Further Action Required
- No additional vaccination is needed - you have already achieved protective immunity 3
- No routine follow-up testing is necessary for immunocompetent individuals 2
- You are not infectious and pose no transmission risk 3
Understanding "Abnormal" Notation
The "abnormal" flag on your HBsAb result is a laboratory reporting convention indicating a positive/reactive test. This is actually the desired result after vaccination, not a medical problem. 1, 2
Durability of Protection
Your immunity typically persists even if antibody levels decline over time. 3, 4
- Antibody levels (anti-HBs titers) may wane years after vaccination, but immunologic memory generally maintains protection 3, 4
- Routine booster doses are not recommended for immunocompetent individuals with documented vaccine response 3
Special Circumstances Requiring Monitoring
If You Require Immunosuppressive Therapy
Your risk of HBV reactivation is minimal because you lack HBcAb (no prior natural infection that could reactivate). 1, 2, 3
However, if you need significant immunosuppression (chemotherapy, anti-CD20 antibodies like rituximab, high-dose corticosteroids), consider:
- Checking anti-HBs levels before starting therapy 3
- Monitoring for potential loss of immunity during prolonged immunosuppression 2, 3
- Booster vaccination if anti-HBs levels are low prior to immunosuppressive therapy 3
High-Risk Healthcare or Dialysis Settings
- Annual anti-HBs screening may be recommended in dialysis units 1, 2
- Healthcare workers with ongoing exposure risk may require periodic monitoring 2
Key Distinction from Natural Immunity
If you had recovered from natural Hepatitis B infection, you would be both HBsAb-positive AND HBcAb-positive. 1, 3 Your negative HBcAb confirms you achieved immunity through vaccination alone, which carries no risk of viral reactivation even with severe immunosuppression. 1, 2
Common Pitfalls to Avoid
- Do not confuse "abnormal" laboratory flagging with disease - reactive HBsAb is the expected protective response 1, 2
- Do not pursue unnecessary booster vaccinations - immune memory persists despite declining antibody titers in most individuals 3, 4
- Do not assume you need antiviral prophylaxis if requiring immunosuppression - your vaccine-derived immunity without HBcAb means no latent virus exists to reactivate 1, 2