A 25-year-old presents with acute jaundice and malaise. Serology shows HBsAg positive, anti-HBs negative, total anti-HBc positive and IgM anti-HBc strongly positive. This pattern establishes:
- A Resolved hepatitis B with immunity
- B Chronic carrier state of hepatitis B
- C Acute hepatitis B infection ✓
- D Vaccination-induced immunity with coincidental illness
Correct answer: C. Acute hepatitis B infection
Explanation
IgM anti-HBc is the hallmark of acute hepatitis B and appears early, persisting for roughly 4 to 6 months. Its presence with HBsAg positivity confirms recent infection. In a chronic carrier, IgM anti-HBc would be negative while total anti-HBc remains positive. Anti-HBs appears only after clearance or vaccination, so its absence here argues against resolved infection or vaccine-derived immunity.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.