A 32-year-old healthcare worker has the following hepatitis B serology: HBsAg negative, anti-HBs positive (150 IU/L), anti-HBc IgG positive, anti-HBc IgM negative, HBeAg negative, anti-HBe positive. What does this serological profile most likely represent?

• A Active hepatitis B infection with early seroconversion
• B Past resolved hepatitis B infection with natural immunity ✓
• C Successfully vaccinated individual (post-vaccination immunity)
• D Occult hepatitis B infection requiring HBV DNA quantification

Explanation

In resolved natural hepatitis B infection, HBsAg is cleared and anti-HBs antibodies develop (indicating immunity). Anti-HBc IgG (total anti-HBc) remains positive for life after natural infection — this is the key marker distinguishing natural immunity from vaccine-induced immunity. Anti-HBc IgM is absent in resolved infection (present only in acute/reactivation). A vaccinated individual would have anti-HBs positive but anti-HBc negative (vaccine contains only HBsAg, not core antigen). Occult HBV would have HBsAg negative with detectable HBV DNA, but the anti-HBs here at 150 IU/L in a resolved natural infection context makes active occult infection less likely, though HBV DNA could still be checked.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.