A 28-year-old blood donor is found to be HBsAg negative and anti-HBs negative, but total anti-HBc and IgM anti-HBc are positive. Liver enzymes are elevated. This serological profile indicates:

• A Resolved hepatitis B with immunity
• B Post-vaccination immune status
• C Chronic carrier state with low infectivity
• D Window period of acute hepatitis B ✓

Explanation

During the window period of acute hepatitis D, HBsAg has been cleared but anti-HBs has not yet appeared, leaving IgM anti-HBc as the sole marker of ongoing infection. Such units are infectious despite being HBsAg negative, which is why anti-HBc screening matters in donors. Resolved infection shows positive anti-HBs with IgG anti-HBc, while vaccination produces anti-HBs alone without any anti-HBc.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.