About anti-hbc test

Greeting all, i hope this msg finds all well

I have a question regarding anti-hbc resutls.

Lets assume some is vaccinated and vaccination worked with this person and resulted in high Agsab titer like in 1000s units… lets assume that this person was exposed to hep b virus.

Will his body still generate anti-hbc? Despite having high anti-hbs titer ?

Hi F_beauty
Anti HBs is a protective antibody in the blood that can neutralize and destroy HBV if the person was exposed at the titer level of more than 10 mIU/ml , so the virus is eradicated completely and can’t enter into the liver to form ccc DNA in the nucleus of hepatocyte . It means that the person will not have infection by HBV. If the body immune system is suppressed by immunosuppressive drugs, the low level of anti HBs can’t completely neutralize, then HBV can escape and enter to the nucleus of hepatocyte and increase replication and produce core protein leading to inflammation by adaptive immune response(T&B cell lymphocyte )to eradicate viruses and produce Anti HBc in the blood . Anti HBc that occur is the evidence of HBV infection, it can’t destroy the virus because core antigen locate inside the virus , not at the surface of virus like HBsAg . I hope this may answer your questions.

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Hello I am new to this forum. I appreciate the topics that being discussed here.
Related to this question is what happens when someone was previously infected by Chronic HepB and Asymptomatic/inactive and several years later without knowing about the infection gets HepB immunization. How doe this impact or skew your autoimmune response and the serology markers? I understand that immunization after an infection doesn’t help prevent HepB infection. Does it cause harm or complicates the matter if immunized after a HepB infection?

Hi TomPsu

Wellcome to hepbcommunity.org
According to your questions, there is no evidence that HBV vaccine associated with autoimmune diseases from literature review and meta-analysis.

https://search.app/BgzKrd5DiuDExhX58 )
HBV vaccine don’t like covid 19 vaccines that can stimulate body immune response due to the resemblance between specific human proteins and spike protein , then the body immune system mistakes human proteins as pathogens and trigger autoimmune diseases. Study about effects of HBV vaccine in chronic hepatitis B with occult HBV infection (OBI) which is defined by HBsAg-ve , anti HBc +ve , normal ALT and low level of HBV DNA ,showed that vaccine can increase anti HBs , CD4, CD8 T lymphocytes and HBs specific B cells in peripheral blood but this effect isn’t significantly finding in chronic hepatitis B patients with HBsAg +ve due to the impaired body immune response to HBV both innate and adaptive immunity.

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This answer is very good.

John Tavis

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Hi @TomPsu,

@chul_chan’s answer is good. Note that you may have misspoken when you referred to the antibodies raised by the vaccine as being autoimmune. The definition of autoimmune is an immune response against a normal component of the human body. HBV does not induce autoimmunity, but it is easy to be mix up the terms because hepatitis B disease is primarily caused by the immune cells attacking infected hepatocytes, but the attack is against the HBV proteins in the cells, not a normal part of the cells.

Vaccination in the very large majority of people with chronic infection but no symptoms (sometimes called the “immune tolerant” phase or related terms) has no effect at all. The vaccine adds a very small amount of the HBs protein to the body, but the infected liver is putting out a huge amount of HBs (that is actually part of how it blunts the immune responses to HBV by overwhelming the immune system), so the added HBs barely changes what the immune system is seeing. Folks with “occult HBV” have unusual responses to the virus and may respond to the vaccine in some cases, but I’m not an expert in that area of the HBV literature.



I had liver resection a year ago due to HCC stage 2. 50% of my liver was taken . My HBsAntigen is still >150. My CA19 and AFP always normal throughout . If my hepatocytes regenerates, will it contain cccDNA even I continue to take TAF with undectable HVBDNA
Thanks for sharing your knowledge .

Thank you for your clear and understandable answer about immune reactions to HBV vaccine in CHB @ john.tavis
Chulapong Chanta. MD. Pediatrics

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ในวันที่ วันพฤหัสบดี, มิถุนายน 27, 2567, 21:48 John Tavis via Hep B Community info@hepbcommunity.org เขียนว่า:

Hi @Ccheng8346,

Your resection appears to have done a good job removing the cancer based on the limited information in this message, but but extensive followup will still needed as your doctor has surely told you. However, so far so good!!!

Your hepatocytes will lose cccDNA as they divide to repopulate the liver. However, not all hepatocytes will divide, and while the cccDNA remains the cells are still infected and can release infectious HBV, which could infect the newly divided cells that had lost cccDNA. I am assuming from your message that you are still on tenofovir and that you are DNA undetectable, but that does not mean that you have cleared HBV given that you are HBs+. We have a hard time telling who has cleared HBV and who still has a low-level infection because the “biomarkers” we use have sensitivity limits and HBs can be made from integrated HBV DNA even if there is no cccDNA left in a cell.

In short, I recommend discussing this carefully with your doctor and following her/his guidance. The conservative option would be to stay on tenofovir or a similar “nucleos(t)ide analog” such as entecavir for an extended period. Although multiple teams around the world are trying to improve how to determine if someone has cleared HBV, there is no firm answer yet.


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Dear Dr Tavis,

Thank you for responding back so short of times I do appreciate sharing your knowledge. I do hope their is drug in the future that helps for a functional cure

With appreciation,


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