A 28-year-old man tests: HBsAg negative, anti-HBs positive, anti-HBc IgG positive, anti-HBe positive, HBV DNA undetectable. What is the correct interpretation of this serological profile?
- A Acute HBV infection — window period
- B Successful immunity from HBV vaccination
- C Occult HBV infection with low-level viral replication
- D Resolved HBV infection with immunity from past infection ✓
Explanation
Resolved past HBV infection is characterised by HBsAg negative (cleared virus), anti-HBs positive (neutralising antibody), and anti-HBc IgG positive (memory of past infection). The presence of anti-HBc IgG distinguishes past natural infection from vaccine-induced immunity; vaccine recipients have only anti-HBs without anti-HBc. Anti-HBe positive (with loss of HBeAg) and undetectable HBV DNA confirm clearance of active replication. The window period shows isolated anti-HBc IgM with no anti-HBs. Occult HBV has HBsAg negative but detectable HBV DNA at low levels (<200 IU/mL) in serum or liver.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
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