The Hepatitis B Core Antibody Total (Anti-HBc Total) Test detects both IgM and IgG antibodies against the Hepatitis B Core Antigen (HBcAg). This test helps determine past or ongoing HBV infection but does not appear after vaccination.
✅ Detects Past or Current HBV Infection – Unlike Anti-HBs, which appears after vaccination, Anti-HBc indicates exposure to the actual virus.
✅ Differentiates Between Acute and Chronic Infection – Helps classify new vs. old infections when paired with IgM and IgG testing.
✅ Identifies Occult HBV Infection – Some individuals may have HBV DNA in the liver even if other markers are negative.
✅ Assesses Donor Eligibility for Blood Donation – Helps prevent transmission through blood transfusions.
🩸 Blood Sample Collection – A blood sample is analyzed using ELISA (Enzyme-Linked Immunosorbent Assay) or Chemiluminescent Immunoassay (CLIA).
| Anti-HBc Total Result | Interpretation | Next Steps |
|---|---|---|
| Positive (Detected) | Current or past HBV infection | Check HBsAg, Anti-HBs, and HBV DNA to confirm infection status. |
| Negative (Not Detected) | No exposure to HBV | Vaccination may be needed if not immune. |
📌 A positive Anti-HBc alone (with negative HBsAg and Anti-HBs) is called an “isolated Anti-HBc” result and may indicate a past resolved infection, occult HBV, or a false-positive result. Further testing (HBV DNA) may be needed.
| HBV Status | HBsAg | Anti-HBc Total | Anti-HBc IgM | Anti-HBs | HBV DNA |
|---|---|---|---|---|---|
| Acute HBV Infection | Positive | Positive | Positive | Negative | High |
| Chronic HBV Infection | Positive | Positive | Negative | Negative | High/Variable |
| Recovered from HBV | Negative | Positive | Negative | Positive | Undetectable |
| Vaccinated Against HBV | Negative | Negative | Negative | Positive | Undetectable |
| Isolated Anti-HBc | Negative | Positive | Negative | Negative | May be detectable |
📌 Anti-HBc is always positive in past or present HBV infections but not after vaccination.
✔ People with suspected HBV infection (with symptoms or exposure history).
✔ Blood and organ donors (to prevent HBV transmission).
✔ Pregnant women (to assess risk of transmission to the baby).
✔ Individuals with unexplained liver disease (to check for past HBV).
✔ Patients receiving immunosuppressive therapy (to prevent HBV reactivation).
✔ Anti-HBc Total detects both past and current HBV infections but not vaccine immunity.
✔ A positive result requires further tests (HBsAg, Anti-HBs, HBV DNA) to determine infection status.
✔ Isolated Anti-HBc results may indicate past infection, occult HBV, or false positives.
✔ Vaccination is recommended for Anti-HBc-negative individuals who are not immune.