Regarding my hepatitis b reports

Hello Everyone,

Thanks for creating this community. It’s very useful and learned many things by reading various posts and experiences.

I have gone through my blood test recently and my Hepatitis B Core Ab , Igm is reactive.

Below is the brief history:
In year 2016:
No hepatitis b as my uncle expired because of hepatitis c. Whole family went through tests and no issues were found.
Doctor suggested to take 3 doses of hepatitis vaccine.
We took one vaccine every month for 3 months.

In year 2018:
Hepatitis B Core Ab , Igm : Positive Abnormal

In year 2019:
Hep B Surface Ab Qual : Reactive (Consistent with immunity, greater than 9.9 mIU/mL)

In year 2022:
HEPATITIS B SURFACE ANTIGEN (HBSAG) - Negative (value 0.21 OD ratios)

In year 2023:
Hepatitis B Core Ab , Igm : reactive

I read that Hepatitis B Core Ab , Igm should be negative after 6 months. I still see its reactive in 2023 (where it was postive abnormal in 2018).

Can you please help me if I am protected against Hepatitis B. Is there anything to worry about.

All my comprehensive metabolic panel results took each year above are normal. Even in 2023 they are normal.

From posts what I read its clear that I had past Hepatitis B infection (which I didnt know). But wondering why Hepatitis B Core Ab , Igm is still reactive . Will this stay reactive forever ? Any one faced this problem ? Please suggest.

Dear @krisusjs,

Can you please confirm that your HBcAg Ab test is for IgM and not IgG or total Ig (IgM + IgG)?

Best regards,

Hi @availlant ,

Thanks for response.

As I know the test was not done for HBcAg Ab but for HBcAb as below.

In recent 2023 results:

IgM antibodies to hepatitis B core antigen detected, consistent with acute infection.


Thank you

Hi @krisusjs,

So this is a highly unusual situation where you have undetectable HBsAg and anti-HBs but also appear to have persistent anti-HBc IgM. Can you confirm that your ALT levels are normal? Although unlikely, you should discuss a HBV DNA test with your doctor to ensure that there is really no detectable viral replication.

I am not aware of any case reports of situations like yours in the literature (perhaps Thomas is). It is difficult to advise you on how long you will remain positive for anti-HBc IgM.

Best regards,

Hi @availlant ,

Here are my details
ALT is 24
AST is 18
Alubium is 4.6
Globulin 2.4

My doctor suggested going for a blood test (Comprehensive Metabolic Panel) after three months. She mentioned, that in some patients, anti-HBC IGM can stay long and will fade off as days go by. She also asked me to do an acute Hepatitis Panel every year during an annual checkup. No HBV DNA is prescribed.

Thank you

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Hi @krisusjs,

So there is no evidence of liver disease from these results (although a liver ultrasound / fibroscan would provide a more complete assessment). I would agree that with HBsAg loss and anti-HBs seroconversion that it is quite unexpected there would be any viral replication ongoing.

We should respect your physicians experience with prolonged HBcAb IgM positivity. It is also important to understand that there can be great differences between immune function from person to person and you could just be one of these rare individuals where HBcAb IgM persists. However if it does not go away at your next evaluation, you many want to consider a HBV DNA test just to be sure there is not any low lever replication ongoing. This is possible (although very rare) even with HBsAg loss and anti-HBs seroconversion.

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Hi @availlant ,

Thanks for your valuable inputs. Sure will follow as suggested.

Much appreciated for your time and sharing.

Best Regards

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