A 28-year-old woman's hepatitis B serology: HBsAg positive, anti-HBc IgM positive, HBeAg positive, anti-HBs negative. This serological pattern indicates:
- A Acute hepatitis B with high infectivity ✓
- B Resolved acute hepatitis B with immunity
- C Chronic hepatitis B in the immune-tolerant phase
- D Successfully vaccinated individual with recent exposure
Correct answer: A. Acute hepatitis B with high infectivity
Explanation
Anti-HBc IgM is the earliest antibody to appear in hepatitis B infection and is the hallmark marker of acute infection, present even in the window period when HBsAg has declined but anti-HBs has not yet appeared. HBeAg positivity indicates active viral replication and high infectivity (HBV DNA is also typically high). Absence of anti-HBs confirms active infection rather than resolved disease. Vaccination produces isolated anti-HBs without anti-HBc, since it contains only HBsAg and not core antigen.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.