A 30-year-old man has 3 weeks of jaundice. He denies alcohol use and drug intake. Investigations show HBsAg negative, anti-HBs negative, anti-HBc IgM strongly positive, HBV DNA 5000 IU/mL, ALT 900 U/L. The correct interpretation is:
- A Acute hepatitis B in the window period ✓
- B Resolved hepatitis B with immunity
- C Chronic hepatitis B with core antibody escape
- D False positive anti-HBc IgM due to hypergammaglobulinemia
Correct answer: A. Acute hepatitis B in the window period
Explanation
During recovery from acute HBV, HBsAg falls below detection while anti-HBs has not yet appeared, producing the window period. Anti-HBc IgM remains positive throughout acute and early convalescent infection and is the only marker identifying disease at this stage. Resolved infection would show positive anti-HBs together with anti-HBc IgG, not IgM.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.