What does a reactive anti‑HBs (hepatitis B surface antibody), non‑reactive anti‑HBc IgM (hepatitis B core IgM), and reactive anti‑HBs IgG indicate?

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Interpretation of Your Hepatitis B Serology Results

What Your Results Mean

Your serologic pattern—reactive anti-HBs, non-reactive anti-HBc IgM, and reactive anti-HBs IgG—indicates immunity from hepatitis B vaccination, not from natural infection. 1, 2

Detailed Breakdown of Each Marker

  • Reactive anti-HBs (hepatitis B surface antibody): This is the protective antibody against hepatitis B virus. A positive result at ≥10 mIU/mL indicates you have immunity and are protected from HBV infection. 1, 2

  • Non-reactive anti-HBc IgM (hepatitis B core IgM antibody): This marker is negative, which rules out acute hepatitis B infection. IgM anti-HBc appears only during acute infection and typically becomes undetectable within 6 months. 1, 2

  • Reactive anti-HBs IgG: This appears to be referring to anti-HBs measured by IgG class antibody detection, which is the standard method for detecting protective immunity. 1

Critical Distinction: Vaccination vs. Natural Infection

The key to understanding your results is the absence of anti-HBc (total hepatitis B core antibody). 1, 2

  • Vaccine-induced immunity (your pattern): Anti-HBs positive + anti-HBc negative. This means you were vaccinated and responded successfully, but never had natural HBV infection. 1, 2

  • Natural immunity (different pattern): Anti-HBs positive + anti-HBc positive. This would indicate you recovered from a past HBV infection. 1, 2

What This Means for Your Protection

  • You are fully protected against hepatitis B infection. The presence of anti-HBs at protective levels (≥10 mIU/mL) provides immunity. 1, 3

  • No further testing or booster doses are needed if you are immunocompetent (not on dialysis, not HIV-positive, not on chemotherapy, and not otherwise immunosuppressed). 3

  • Your protection is lifelong. The CDC confirms that immunocompetent individuals who achieve protective anti-HBs levels after vaccination maintain protection for 30 years or more, likely for life, even if antibody levels later decline. 3

Special Circumstances Requiring Monitoring

You would need annual anti-HBs testing and booster doses only if you fall into these categories: 3

  • Hemodialysis patients
  • HIV-infected individuals
  • Hematopoietic stem-cell transplant recipients
  • Patients receiving chemotherapy
  • Other immunocompromised conditions

Summary Table from CDC Guidelines

According to the CDC interpretation table, your pattern corresponds to: 1

HBsAg Anti-HBc IgM anti-HBc Anti-HBs Interpretation
Negative Negative Negative Positive Immune from vaccination (if ≥10 mIU/mL)

Bottom line: You are immune to hepatitis B from vaccination, you have never been infected with the virus, and you are protected against future infection. 1, 2, 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Hepatitis B Serology Interpretation

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Hepatitis B Immunity Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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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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