A 30-year-old healthcare worker presents with acute hepatitis. Serology shows HBsAg positive, anti-HBc IgM positive, HBeAg positive, anti-HBs negative. What is the correct interpretation?

• A Resolved hepatitis B infection with immunity
• B Chronic hepatitis B infection, low replication state
• C Hepatitis B vaccination-induced immunity
• D Acute hepatitis B infection, high replicative phase ✓

Explanation

This serological profile — HBsAg+, anti-HBc IgM+, HBeAg+, anti-HBs− — is diagnostic of acute hepatitis B in the high-replication phase. Anti-HBc IgM is the first antibody to appear and is the marker of acute infection; IgG anti-HBc indicates past or chronic infection. HBeAg positivity indicates active viral replication and high infectivity. Vaccination induces only anti-HBs without anti-HBc, since the vaccine contains only the surface antigen.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.