# HBV Serology Tool URL: https://openhbv.bangbo.dev/tools/hbv-serology?locale=en Canonical Markdown: https://openhbv.bangbo.dev/tools/hbv-serology.md?locale=en Language: en ## Summary Select marker results to see educational possibilities and next-step questions to discuss with a clinician. This tool is based on public health references in the OpenHBV source library. It organizes possible meanings only and cannot replace a clinician's judgment. ## Inputs - HBsAg Options: Positive, Negative, Unknown Quantitative value: Quantitative value (optional) Default unit hint: IU/mL or S/CO - Anti-HBs Options: Positive, Negative, Unknown Quantitative value: Quantitative value (optional) Default unit hint: mIU/mL - HBeAg Options: Positive, Negative, Unknown Quantitative value: Quantitative value (optional) Default unit hint: S/CO - Anti-HBe Options: Positive, Negative, Unknown Quantitative value: Quantitative value (optional) Default unit hint: S/CO - Anti-HBc Options: Positive, Negative, Unknown Quantitative value: Quantitative value (optional) Default unit hint: S/CO Quantitative values are recorded only to preserve report context. Except for the commonly used post-vaccination Anti-HBs reference threshold of 10 mIU/mL, this tool does not replace the laboratory reference range, assay notes, or clinician judgment. ## Marker Guide - HBsAg: Hepatitis B surface antigen. A positive result may suggest current HBV infection. - Anti-HBs: Hepatitis B surface antibody. Positivity may be seen after vaccination or recovery from past infection. - Anti-HBc: Hepatitis B core antibody. Positivity suggests past or current exposure to HBV; vaccination alone usually does not make it positive. - HBeAg: Hepatitis B e antigen. Often used with HBV DNA to assess viral replication. - Anti-HBe: Hepatitis B e antibody. Interpret together with HBeAg, HBV DNA, and liver tests. ## Educational interpretation ### Pattern may suggest current HBV infection HBsAg and anti-HBc positivity may be seen in current HBV infection, but this pattern cannot determine acute versus chronic infection by itself. Possible meanings: - This may suggest current HBV infection. - Further testing and clinical history are needed before any conclusion. Suggested next steps: - Discuss HBV DNA, ALT/AST, bilirubin, platelet count, liver ultrasound, and fibrosis assessment with a doctor. - Ask a qualified clinician whether specialist liver or infectious disease care is appropriate. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest current HBV infection with viral replication HBsAg, anti-HBc, and HBeAg positivity may be seen when HBV is actively replicating. HBV DNA testing is needed to understand viral level. Possible meanings: - This may suggest current HBV infection. - HBeAg positivity may suggest active viral replication. Suggested next steps: - Seek medical evaluation and HBV DNA testing. - Do not start, stop, or change antiviral medicine without a qualified clinician. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest current HBV infection with HBeAg negativity HBsAg and anti-HBc positivity may suggest current HBV infection. HBeAg negativity with anti-HBe positivity may be seen with lower replication or HBeAg-negative chronic hepatitis B, but HBV DNA and liver tests are still needed. Possible meanings: - This may suggest current HBV infection. - HBeAg negativity does not mean there is no viral replication or no need for follow-up. Suggested next steps: - Discuss HBV DNA, ALT/AST, liver ultrasound, and fibrosis assessment with a doctor. - Follow medical advice for monitoring and do not change treatment on your own. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern needs confirmation: HBsAg positive but anti-HBc negative HBsAg positivity with anti-HBc negativity is uncommon and may be seen with very early infection, testing error, false positivity, or incomplete data. Possible meanings: - This is not enough for a clear interpretation by itself. - The result and timing may need confirmation. Suggested next steps: - Consider repeating HBsAg and anti-HBc total/IgM and adding HBV DNA. - Review the full report with a clinician, especially after recent exposure or symptoms. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### HBsAg positivity needs further evaluation HBsAg positivity may suggest current HBV infection, but anti-HBc, HBV DNA, liver tests, and prior results are important for interpretation. Possible meanings: - This may suggest current HBV infection. - The current inputs are not enough to determine stage or treatment need. Suggested next steps: - Confirm anti-HBc, HBeAg, anti-HBe, HBV DNA, and ALT/AST. - Ask a doctor to interpret results with history and local guidance. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest immunity from vaccination HBsAg negativity with anti-HBs positivity and anti-HBc negativity may be seen after successful hepatitis B vaccination. Possible meanings: - This may suggest vaccine-derived immunity. - Clinical context and exact lab thresholds still matter. Suggested next steps: - Keep a copy of vaccination and lab records. - Ask a clinician if booster or repeat testing is needed for your situation. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest past infection and recovery HBsAg negativity with anti-HBs and anti-HBc positivity may be seen after past HBV infection and recovery. Possible meanings: - This may suggest past HBV exposure with recovery. - Some people need follow-up in special situations such as immunosuppression. Suggested next steps: - Discuss the result with a doctor, especially before chemotherapy, immune-suppressing treatment, or pregnancy. - Ask whether HBV DNA or liver tests are needed. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest no evidence of infection or immunity When HBsAg, anti-HBs, and anti-HBc are all negative, the pattern may suggest no current infection and no detectable immunity. Possible meanings: - This may suggest susceptibility to HBV. - Vaccination may be appropriate depending on age, risk, and local guidance. Suggested next steps: - Discuss hepatitis B vaccination with a clinician. - Consider repeat or confirmatory testing if exposure was recent. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest isolated anti-HBc positivity HBsAg negative, anti-HBs negative, and anti-HBc positive is often called isolated core antibody positivity. It may be seen after past infection with waning antibody, false positivity, window period, or rarely occult infection. Possible meanings: - This may suggest prior HBV exposure. - False positivity or recent infection window period may need to be considered. Suggested next steps: - Discuss repeat anti-HBc, anti-HBs, and possible HBV DNA testing with a clinician. - Tell a doctor before chemotherapy, immune-suppressing treatment, or transplant evaluation. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern may suggest antibody protection, but source is unclear HBsAg negativity with anti-HBs positivity may suggest immunity, but when anti-HBc is unknown or the pattern is incomplete, the source of immunity cannot be determined. Possible meanings: - This may suggest detectable anti-HBs antibody. - Whether immunity came from vaccination or past infection depends on anti-HBc and history. Suggested next steps: - Review quantitative anti-HBs and anti-HBc results. - Consult a clinician if immunosuppression, pregnancy, or recent exposure is relevant. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ### Pattern needs clinical context This combination is incomplete or less specific. HBV serology interpretation depends on complete testing, timing, symptoms, vaccination history, and local lab thresholds. Possible meanings: - This may require repeat or additional testing. - A definitive diagnosis cannot be made from this tool. Suggested next steps: - Review the full lab report with a qualified doctor. - Ask whether HBV DNA, ALT/AST, and repeat serology are needed. Cannot Determine: It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ## Cannot Determine It cannot determine acute versus chronic infection, infectiousness, whether treatment is needed, whether medicine can be stopped, or replace a clinician's assessment using history, full tests, and local guidance. ## Disclaimer This tool is for health education only and does not provide a personal diagnosis or treatment advice. Please consult a qualified doctor for individual medical decisions. ## Source Backing - CDC Hepatitis B Prevention and Control Source record: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-prevention-and-control?locale=en Source Markdown: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-prevention-and-control.md?locale=en Original URL: https://www.cdc.gov/hepatitis-b/prevention/index.html Organization: Centers for Disease Control and Prevention Published: not listed Source updated: not listed Last checked: 2026-06-26 Credibility note: 国家公共卫生机构 Summary: CDC 关于乙肝传播方式、家庭和伴侣风险、疫苗、检测和预防措施的公众说明。 - CDC Hepatitis B Testing and Diagnosis Source record: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-testing-and-diagnosis?locale=en Source Markdown: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-testing-and-diagnosis.md?locale=en Original URL: https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/index.html Organization: Centers for Disease Control and Prevention Published: not listed Source updated: not listed Last checked: 2026-06-26 Credibility note: 国家公共卫生机构 Summary: CDC 关于乙肝筛查、诊断和血清学标志物解释的专业指导。 - CDC Hepatitis B Vaccine Administration Source record: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-vaccine-administration?locale=en Source Markdown: https://openhbv.bangbo.dev/sources/cdc-hepatitis-b-vaccine-administration.md?locale=en Original URL: https://www.cdc.gov/hepatitis-b/hcp/vaccine-administration/index.html Organization: Centers for Disease Control and Prevention Published: not listed Source updated: not listed Last checked: 2026-06-26 Credibility note: 国家公共卫生机构 Summary: CDC 关于乙肝疫苗接种对象、筛查检测与疫苗接种衔接、成年人和风险人群接种建议的临床给药说明。 - WHO Hepatitis B Fact Sheet Source record: https://openhbv.bangbo.dev/sources/who-hepatitis-b-fact-sheet?locale=en Source Markdown: https://openhbv.bangbo.dev/sources/who-hepatitis-b-fact-sheet.md?locale=en Original URL: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b Organization: World Health Organization Published: not listed Source updated: not listed Last checked: 2026-06-26 Credibility note: 权威公共卫生来源 Summary: WHO 关于乙肝传播、预防、疫苗、检测、治疗和全球公共卫生影响的概览。