Can you interpret my hepatitis serology results: hepatitis A total antibody positive, hepatitis A IgM negative; hepatitis B surface antigen negative, surface antibody non‑reactive, core total antibody negative; hepatitis C antibody non‑reactive, and advise what to do next?

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Hepatitis Serology Interpretation

Your Results Indicate Past Hepatitis A Infection and Susceptibility to Hepatitis B

You have immunity to hepatitis A from past infection, no current hepatitis B or C infection, but you are susceptible to hepatitis B and should receive the hepatitis B vaccine series. 1, 2

Hepatitis A Status: Past Infection with Immunity

  • Hepatitis A total antibody positive with IgM negative confirms past hepatitis A infection with lifelong immunity. 1, 2
  • The total antibody test detects both IgG and IgM; your negative IgM rules out acute or recent infection. 1
  • IgG anti-HAV (total anti-HAV) persists for life after infection and confers permanent protection. 2
  • No further hepatitis A testing or vaccination is needed. 1

Hepatitis B Status: Susceptible (Never Infected, Not Vaccinated)

Critical Interpretation

Your serologic pattern—HBsAg negative, anti-HBs non-reactive, and anti-HBc negative—definitively indicates you have never been infected with hepatitis B and have no immunity from vaccination. 3, 2

  • This pattern is classified as "susceptible" by the CDC, meaning you are at risk for hepatitis B infection if exposed. 3
  • Anti-HBs levels below 10 mIU/mL (non-reactive) indicate no protective immunity. 3, 4
  • Anti-HBc is the permanent marker of natural hepatitis B exposure; its absence confirms you have never been infected. 2, 5

Immediate Action Required: Hepatitis B Vaccination

You should receive the complete hepatitis B vaccine series immediately. 3, 4

  • The standard schedule is 3 doses at 0,1, and 6 months. 4
  • After vaccination, you will develop anti-HBs (without anti-HBc), confirming vaccine-induced immunity. 1, 2
  • Protective immunity is defined as anti-HBs ≥10 mIU/mL. 3, 4
  • The CDC and American Academy of Pediatrics recommend universal hepatitis B vaccination for all unvaccinated individuals. 4

Why Vaccination Is Critical

  • Hepatitis B can cause acute massive hepatic necrosis, chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. 4
  • Up to 6-10% of infected adults become chronic carriers who can transmit the virus and face increased risk of liver cancer. 4
  • The hepatitis B vaccine is recognized as the first anti-cancer vaccine because it prevents primary liver cancer. 4
  • There is no specific treatment for acute hepatitis B infection, making prevention through vaccination essential. 4

Hepatitis C Status: No Evidence of Infection

  • Hepatitis C antibody non-reactive indicates you have not been infected with hepatitis C virus. 3, 1
  • A negative HCV antibody test rules out hepatitis C infection unless you have very early acute infection (within the first few weeks of exposure) or are severely immunocompromised. 1
  • No further hepatitis C testing is needed unless you develop symptoms of acute hepatitis or have a known high-risk exposure. 1

Summary of Next Steps

  1. Schedule hepatitis B vaccination immediately (3-dose series at 0,1, and 6 months). 3, 4
  2. Confirm protective immunity 1-2 months after completing the vaccine series by testing anti-HBs levels (target ≥10 mIU/mL). 3, 4
  3. No further testing needed for hepatitis A (you have lifelong immunity) or hepatitis C (you are not infected). 1
  4. Counsel on hepatitis B prevention until vaccination is complete: avoid sharing needles, razors, or toothbrushes; use barrier protection during sexual activity; and inform healthcare providers of your susceptibility before any procedures. 3

Common Pitfalls to Avoid

  • Do not assume you are immune to hepatitis B simply because you have not been diagnosed with it; immunity requires either vaccination or documented past infection with anti-HBs ≥10 mIU/mL. 3, 2
  • Do not delay hepatitis B vaccination; susceptible individuals remain at risk for infection from occupational exposure, sexual contact, or household transmission. 3, 4
  • After vaccination, verify protective immunity with anti-HBs testing, as 5-10% of vaccine recipients may not respond adequately and require revaccination or higher doses. 4

References

1
Guideline

Interpretation of Hepatitis B and C Serology Results

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

2
Guideline

Hepatitis B Serology Interpretation

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

3
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

5
Guideline

Hepatitis B Diagnosis and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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