Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1369 page)

   Positive anti-HBc total antibody test results should be correlated with the presence of other HBV serologic markers, elevated liver enzymes, clinical signs and symptoms, and a history of risk factors.

   Low levels of IgM core antibodies can sometimes be present in chronic hepatitis B, particularly during flares of activity and at times of conversion from positive antigen to positive antibody.

   Neonates (<1-month-old) with positive anti-HBc total antibody results from this assay method should be tested for anti-HBc IgM antibody to rule out possible maternal anti-HBc total antibody causing false-positive results. Repeat testing for anti-HBc total antibody within 1 month is also recommended in these neonates.

HEPATITIS B SURFACE ANTIBODY (HBsAB)

   Definition

   The presence of HBsAb in the serum generally indicates recovery and immunity from hepatitis B infection. With naturally occurring hepatitis infections, anti-HBs usually appear in serum several weeks after disappearance of HBsAg; also known as HBsAb, anti-HBs, Australia Bs antibody, and HBV antibody.

   
Normal range:

   <5.00 mIU/mL: Negative

   ≥5.00 mIU/mL and <12.0 mIU/mL: Indeterminate

   ≥12.0 mIU/mL: Positive

   Use

   Identifying current and previous exposure to HBV. Determining adequate immunity from hepatitis B vaccination

   Interpretation

Increased In

   Recovery from acute or chronic HBV infection, or acquired immunity from HBV vaccination.