Hepatitis B Immunity Status Test

Hepatitis B is a viral infection caused by the hepatitis B virus (HBV), a highly contagious, double-shelled DNA virus. It is transmitted through contact with infected blood or bodily fluids, including through sexual contact, sharing needles, or from mother to child during birth. Hepatitis B is a preventable sexually transmitted disease (STD), and effective vaccines have been available since the 1980s.

While many adults infected with HBV experience an acute, self-limited illness, others, especially infants and young children, may progress to chronic hepatitis B, increasing their risk for cirrhosis and hepatocellular carcinoma.

What's In This Test:

Hepatitis B Surface Antibody (Anti-HBs) Screening;

• This antibody develops when a person has successfully responded to the hepatitis B vaccine or has recovered from a natural HBV infection.
• The presence of Anti-HBs indicates immunity, the body now has protective antibodies that can recognize and fight the virus.
• After clearing a natural infection, Anti-HBs levels typically remain detectable long-term and provide lifelong protection against reinfection.
• Vaccination works by stimulating the immune system to produce these same protective antibodies.

Hepatitis B Core Antibody (Anti-HBc) Screening;

• Anti-HBc appears when a person has been exposed to the virus itself, either currently or in the past.
• It does not appear in individuals who have only been vaccinated, since the vaccine does not contain the hepatitis B core antigen.
• Its presence can indicate a past resolved infection (natural immunity) or signal a current/recent infection to which the HBsAg test results would be helpful in determining an active infection.

Hepatitis B Surface Antigen (HBsAg)

• Detection of HBsAg indicates an active HBV infection.
• Individuals with persistent HBsAg for more than six months are considered to have chronic hepatitis B.

Why This Test Matters:

These three hepatitis B tests matter because together they provide a complete picture of a person’s immunity and infection status, something no single test can determine on its own. 

• The hepatitis B surface antibody (Anti-HBs) shows whether a person is immune, either from successful vaccination or from recovering naturally from a past infection. 
• The hepatitis B core antibody (Anti-HBc) indicates whether someone has ever been exposed to the actual virus, helping distinguish natural immunity from vaccine-induced immunity. Because the core antibody appears only after real infection, it is a key marker for identifying past exposure, current infection, or the need for further evaluation when results are unclear.
• The hepatitis B surface antigen (HBsAg) is essential for determining whether a person currently has an active infection. A positive HBsAg result means the virus is present and the individual may be contagious. 

When these three tests are used together, healthcare providers can determine if someone is immune, currently infected, previously exposed, or still susceptible and in need of vaccination. This combined approach guides appropriate clinical decisions such as monitoring, treatment evaluation, and public health interventions.

How Hepatitis B Spreads:

Hepatitis B spreads when blood or certain body fluids from an infected person enter another person’s body. Cases include some of the following;

• Sexual contact with an infected partner
• Sharing needles, syringes, or sharp personal items (razors, toothbrushes)
• Needlestick injuries or other blood-to-blood exposure
• Mother-to-child transmission during childbirth
• Contact with open cuts or sores of an infected person

Because the virus is so resilient and easily transmitted, knowing your status provides peace of mind and helps prevent further spread.

What Your Results May Indicate:

1. Susceptible to HBV Infection (Not Immune)

• Hepatitis B Surface Antigen: Negative
• Hepatitis B Core Antibody (total): Negative
• Hepatitis B Surface Antibody: Negative

Indicates: No immunity and no evidence of past or current infection. Vaccination is recommended.

2. Immune Due to Vaccination

• Hepatitis B Surface Antigen: Negative
• Hepatitis B Core Antibody (total): Negative
• Hepatitis B Surface Antibody: Positive

Indicates: Immunity comes from vaccination only. The person has never been infected with hepatitis B.

3. Immune Due to Natural Infection

• Hepatitis B Surface Antigen: Negative
• Hepatitis B Core Antibody (total): Positive
• Hepatitis B Surface Antibody: Positive

Indicates: A past natural infection that has resolved. The person now has long-term natural immunity.

4. Active Infection (Acute or Chronic – Cannot Distinguish Without Additional Tests)

• Hepatitis B Surface Antigen: Positive
• Hepatitis B Core Antibody (total): Positive
• Hepatitis B Surface Antibody: Negative

Indicates: An ongoing hepatitis B infection. This pattern can represent either a recent (acute) infection or a long-term (chronic) infection. Additional testing, such as viral load (HBV DNA) and possibly IgM, though not included here, is needed to determine which.

5. Recovering From Natural Infection (Surface Antibody Developing)

• Hepatitis B Surface Antigen: Negative
• Hepatitis B Core Antibody (total): Positive
• Hepatitis B Surface Antibody: Low Positive (Beginning to appear)

Indicates: The individual has recently cleared a natural infection and is developing natural immunity.

Who Is at Higher Risk?

While anyone can be infected, risk increases with certain behaviours or exposures.

CDC Screening Recommendations for Hepatitis B:

• People born in regions with high HBV rates
• Men who have sex with men
• People who inject drugs
• People with HIV
• Individuals needing immunosuppressive therapy
• Those with elevated liver enzymes
• People with end-stage renal disease
• Pregnant individuals

Why You Shouldn’t Wait To Test:

When hepatitis goes undiagnosed, the virus can continue damaging the liver without you realising it, often for years. Because many people have few or no symptoms, the infection can quietly progress and lead to serious health complications, including:

• Chronic liver inflammation: Ongoing inflammation gradually weakens the liver and reduces its ability to function properly.
• Liver scarring (cirrhosis): Long-term damage can lead to scar tissue replacing healthy liver tissue. Cirrhosis is irreversible and can cause significant health problems.
• Liver failure: As liver function declines, the body can no longer filter toxins, produce essential proteins, or support digestion, leading to life-threatening complications.
• Liver cancer: Chronic hepatitis significantly increases the risk of developing hepatocellular carcinoma, the most common form of liver cancer.
• Serious health symptoms over time: Untreated hepatitis can eventually cause jaundice, abdominal swelling, confusion, bleeding disorders, and extreme fatigue as the liver deteriorates.
• Transmission to others: Without knowing your status, you may unintentionally put partners or household members at risk.

Delaying testing can leave you unsure about your health and unaware of a potential hepatitis infection that may already be affecting your liver. Because many people experience mild or no symptoms, waiting can allow silent damage to progress without your knowledge. Testing now provides clarity, helps protect your long-term liver health, and ensures you can take the right steps sooner rather than later. Early awareness empowers you to safeguard both yourself and those around you.

Who Should Consider This Test?

You may want to get tested if you believe you’ve been exposed to hepatitis, even if you feel completely well.

Testing is also recommended for anyone experiencing symptoms such as:

• Fever
• Nausea or vomiting
• Abdominal discomfort
• Fatigue
• Diarrhea
• Jaundice (yellow skin or eyes, dark urine)
• Loss of appetite
• Pale or clay-colored stool
• Joint pain

Many people with hepatitis may have mild or no symptoms at all. That’s why proactive testing is key.

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