In interpreting a hepatitis B serology panel: HBsAg negative, anti-HBs positive (>10 mIU/mL), anti-HBc IgG positive, HBeAg negative, anti-HBe positive. Which clinical scenario does this represent?
- A Resolved past HBV infection with natural immunity ✓
- B Acute hepatitis B infection in early window period
- C Chronic hepatitis B with HBeAg seroconversion
- D Vaccine-induced immunity to hepatitis B
Correct answer: A. Resolved past HBV infection with natural immunity
Explanation
Resolved past HBV infection is characterised by: cleared HBsAg (not detectable), presence of anti-HBs (protective neutralising antibody), and positive anti-HBc IgG (indicating past natural exposure, as vaccine does not induce anti-HBc). Anti-HBe positivity confirms clearance of HBeAg (e antigen seroconversion). In contrast, vaccine-induced immunity produces only anti-HBs without anti-HBc, since the vaccine contains only HBsAg. Chronic infection would have persistent HBsAg.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
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