From the Guidelines
The test results indicate past hepatitis B infection with immunity and possible current hepatitis C infection that requires further testing. The positive hepatitis B surface antibody (anti-HBs) shows you have immunity to hepatitis B, either from past infection that resolved or from vaccination 1. The reactive hepatitis C antibody test suggests exposure to the hepatitis C virus, but doesn't confirm active infection 1. You need a follow-up HCV RNA test to determine if you have an active hepatitis C infection. If the HCV RNA test is positive, you should consult with a hepatologist or infectious disease specialist for treatment evaluation. Modern direct-acting antiviral medications like sofosbuvir/velpatasvir (Epclusa) or glecaprevir/pibrentasvir (Mavyret) can cure hepatitis C in 8-12 weeks with few side effects 1. While you have immunity against hepatitis B, hepatitis C can cause chronic liver inflammation that may lead to cirrhosis or liver cancer if left untreated, which is why confirming active infection status is crucial. Key considerations for hepatitis C treatment include determining the HCV genotype and subtypes, as different genotypes and subtypes vary in virologic response to current treatment regimens and in likelihood of antiviral resistance before or during direct-acting antiviral (DAA) treatment 1. It is also important to screen for evidence of prior or current HBV infection before initiating DAA therapy for hepatitis C, as reactivation of HBV can occur during and after DAA therapy 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Hepatitis B Surface Antibody Positive and Hepatitis C Virus Antibody Test Reactive
- A hepatitis B surface antibody (anti-HBs) positive result indicates that an individual has immunity to hepatitis B virus (HBV) infection, either through vaccination or past infection 2, 3.
- The presence of anti-HBs confers protection against HBV infection, as shown in a study where HBsAg-negative and anti-HBc-positive patients with anti-HBs had a lower risk of HBV infection after kidney transplantation 4.
- A hepatitis C virus (HCV) antibody test reactive result indicates that an individual has been exposed to HCV at some point in their lives.
- The combination of anti-HBs positive and HCV antibody test reactive results suggests that the individual has immunity to HBV and has been exposed to HCV, but does not provide information on the current status of HCV infection.
- Studies have shown that the presence of anti-HBs may also protect against hepatitis B reactivation in individuals undergoing direct-acting antiviral therapy for HCV, especially if the anti-HBs titre is greater than 30 iU/L 5.
Implications of Test Results
- The individual's anti-HBs positive result indicates that they are protected against HBV infection, but it is essential to consider the HCV antibody test reactive result in the context of their overall health and medical history.
- Further testing, such as HCV RNA or liver function tests, may be necessary to determine the current status of HCV infection and to guide treatment decisions.
- The individual's healthcare provider should consider the results of these tests, along with other factors, such as medical history and risk factors, to provide appropriate care and guidance.