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Hepatitis B virus (HBV) is a DNA virus that is endemic throughout the world. In the initial (acute) phase of infection, anti-hepatitis B core antibodies (anti-HBc) consist almost entirely of the IgM antibody class and appear shortly after the onset of symptoms. Anti-HBc IgM antibody can be detected in serum and is usually present for up to 6 months after acute HBV infection. Anti-HBc IgM may be the only serologic marker of a recent hepatitis B infection detectable following the disappearance of hepatitis B surface antigen (HBsAg) and prior to the appearance of hepatitis B surface antibody (anti-HBs) (ie, serologic window period).
See Viral Hepatitis Serologic Profile in Special Instructions and The Laboratory Approach to the Diagnosis and Monitoring of Hepatitis B Infection in Publications.
Diagnosis of acute hepatitis B infection
Identifying acute hepatitis B virus (HBV) infection in the serologic window period when hepatitis B surface antigen and anti-hepatitis B surface are negative
Differentiation between acute and chronic/past hepatitis B infection in the presence of positive anti-hepatitis B core
A positive result indicates recent acute hepatitis B infection.
A negative result suggests lack of recent exposure to the virus in preceding 6 months.
The predictive value of a positive anti-hepatitis B core (anti-HBc) IgM test result is low when used to test specimens from patients with low prevalence of acute hepatitis B virus infection.
Performance characteristics have not been established for the following specimen characteristics:
-Grossly icteric (total bilirubin level of >20 mg/dL)
-Grossly lipemic (triolein level of >3,000 mg/dL)
-Grossly hemolyzed (hemoglobin level of >500 mg/dL)
-Containing particulate matter
See Viral Hepatitis Serologic Profiles in Special Instructions.
1. Badur S, Akgun A: Diagnosis of hepatitis B infections and monitoring of treatment. J Clin Virol 2001;21:229-237
2. Servoss JC, Friedman LS: Serologic and molecular diagnosis of hepatitis B virus. Clin Liver Dis 2004;8:267-281