Table 5 – STI Treatment Guidelines

Interpretation of serologic test results* for hepatitis B virus infection

Table 5
Serologic marker				Interpretation
HBsAg	Total anti-HBc	IgM anti-HBc	Anti-HBs	Interpretation
–	–	–	–	Never infected
+†	–	–	–	Early acute infection; transient (≤18 days) after vaccination
+	+	+	–	Acute infection
–	+	+	–	Acute resolving infection
–	+	–	+	Recovered from past infection and immune
+	+	–	–	Chronic infection
–	+	–	–	Past infection; low-level chronic infection§; passive transfer to infant born to HBsAg-positive mother; false positive (no infection)
–	–	–	+	Immune if concentration is >10 mIU/mL after vaccination, passive transfer after HBIG administration

Source: Adapted from Schillie S, Vellozzi C, Reingold A, et al. Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2018;67(No. RR-1).

Abbreviations: anti-HBc = antibody to hepatitis B core antigen; anti-HBs = antibody to hepatitis B surface antigen; HBIG = hepatitis B immune globulin; HBsAg = hepatitis B surface antigen; IgM = immunoglobulin M.

* – = negative test result; + = positive test result.

^†To ensure that an HBsAg-positive test result is not false positive, samples with repeatedly reactive HBsAg results should be tested with a neutralizing confirmatory test cleared by the Food and Drug Administration.

^§Persons positive for only anti-HBc are unlikely to be infectious, except under unusual circumstances involving direct percutaneous exposure to large quantities of blood (e.g., blood transfusion or organ transplantation) or mutant HBsAg-related infection.

Page last reviewed: July 22, 2021

Content source: Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention