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  • Hepatitis B
  • For Adults (Including HBV Screening)

What do I do with an adult whose triple panel hepatitis B screening result shows only the total core antibody (anti-HBc) is positive?

There a several potential interpretations of an isolated anti-HBc positive result (with a negative HBsAg and negative anti-HBs). Additional evaluation of the patient’s immune status and risk history is needed. A 2011–2018 national survey found the prevalence of isolated positive anti-HBc is about 0.8%. The total anti-HBc tests are very accurate, at about 99.8% specificity; however, if a person has no risk factors for hepatitis B, the result may be a false positive. Other possibilities include: a past resolved infection; an occult infection (HBV DNA is detectable but surface antigen is not detected); an early infection tested during the brief period of time before anti-HBs antibodies are detectable; or, an infection with a hepatitis B virus with a mutant surface antigen not detectable by standard tests. Depending upon the circumstances, consultation with a specialist may be helpful.

Additional resources for the evaluation of isolated anti-HBc antibody results are available from the University of Washington: core-concept/all and from CDC:

Last reviewed: July 21, 2023

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