Understanding lab results

Im currently pregnant and was tested for hepatitis b. My Hbsag came back reactive but Hbcab total was non reactive and Hbsab came back <5 & says i do not have immunity to the virus. Is there a chance i have the virus or could this be a false postive? I received the full dose of hep b vaccine at birth.

Dear @Lsm1006 ,

Rebound of HBV viral infection following birth dose vaccination does happen in 5-10% of people with mothers who were infected with HBV at birth. This may or may not be the situation in your case.

I agree that your result is confusing since you appear to be HBsAg positive but HBcAb total negative. This may be a result of a mutation in the HBcAg protein gene which prevents the formation of a normal HBcAb response detectable by standard tests.

You should get a HBV DNA test to settle the issue. Also important is your liver function tests (ALT/AST) - are these normal?

Best regards,

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I recently got my test results back. HBcAB negative, HBsAG negative, and HBsAB reactive high15.96 iu/ml. All LFTs normal besides ALT 45 which ULN is 44. Just noticed that HBV pcr quant was 10<IU/ML. Confused if this result was a false positive? I have never been diagnosed with acute or chronic hep b

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Hi Vpaz9309 and welcome to the forum.

Have you been vaccinated? Was your HBV DNA result < 10 IU/mL? I would check back with the lab and see if it was target not detected. Some labs will not report this.

Best regards,

I have been vaccinated. And yes that was my HBV DNA PCR quant. It has been driving me nuts.I know I’m vaccinated and results show I’m protected. But no signs of anything but the DNA. But from what I’m reading it’s 56<copies if indeed it’s not a false reading or just a misrepresentation of not detected. Sorry for last post it was <10 iu/ml

Hi @Vpaz9309 ,

I really think your HBV DNA is target not detected and the test lab is reporting as < 10IU/mL. I don’t think this is a false positive (especially since HBcAb is negative) its just a confusion with the way the result is reported.

Best regards,


Hello. I just received my lab results and I found out my Anti HBc is reactive and my Anti HBs is >1000. Aside from that, my HBV DNA is 4.4 iu/ml, HBe- Antigen is Negative and lastly my Anti HBe is negative Does it mean I still have Hep b or I am immune to the disease?

I was tested in July of 2022 and my results showed the hep b surface antigen was reactive everything else was normal as far as the liver panel when they tested it again 6 months later everything was exactly the same with my numbers and still the only thing showing reactive was the surface antigen. The gastroenterologist seemed confused because my results are rare and they don’t have many answers for me I am curious if anyone else has had experience with the same results and what they mean?

Dear @Kleekz,

I think these would be interpreted as a potential false positive for the PCR, 4.4IU/mL is lower than the quantitative limit of most HBV DNA PCRs.

Dear @alicia_b9298,

What other tests were done in this case?


They have done a liver panel, Hep B surface antigen, Hep BE virus antigen, metabolic panel, Hep B surface antibody was <3.10, Hep B core antibodies, hep b surface antibody, complete blood count, prothrombin time with INR, hep b DNA, Hep b acute panel, alanine aminotransferase, and a fibroscan. They have done those each 3 times and each time the surface antigen has been reactive and everything else stayed negative DNA undetected and numbers are normal. The initial testing was an STD screening.

Dear @alicia_b9298,

Yes, it is odd that the HBV core antibodies and HBV DNA are negative while the HBsAg is positive. I am unsure what the approach would be in this case. @Pietro_Lampertico, @simone.strasser, @MarkDouglas, any comment here would be welcome!


Hi Experts,

According to various sources, when an adult with late acute hep B infection shows the absence of Hepatitis B e Antigen (HBeAg) and the presence of Hepatitis B e Antibody (HBeAb), it generally indicates a positive progression towards resolving the infection.

However, is it still possible for an adult with late acute HBV infection to develop chronic hepatitis B, even if their HBeAb is already positive?


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Could it be a mutant strain or something? And I am taking it by your response that you haven’t seen test results like this either?

Dear @GodisGood, I’m not aware of any studies looking at this…

No I haven’t seen test results like this. I’m not sure what kind of mutations would even lead to this sort of profile. @alicia_b9298, it might be worth getting a quantitative HBsAg reading to see if this is a high level of signal. If it is very low/borderline, it is more likely to be a false positive reading.


I have a test that says Hepatitis B Virus (HBV) by Quantitative. Would that be the one you’re talking about? That one also says “not detected”. I was trying to upload the results on here but its not working. Also how likely is it that the hepatitis b surface antigen comes back reactive 3 times in 6 months if it was a false positive?

Hi @alicia_b9298,

It’s hard to know what has been tested with your description “Hepatitis B Virus (HBV) by Quantitative”. Are there any other descriptors with the test?

This is probably not very likely…


I just had the doctor order a qualitative test for me I should have the results by next week.

Good to hear and hope it comes back with clarifying news.



I have had night sweats for years and in a recent blood test it was found that my liver enzymes were high. Liver ultrasound came back normal. I tested positive for Hep B Core AB total but negative for everything else that was tested (negative HBsAg Screen and negative Hep B core Ab Igm).

We waited a month to retest again and liver enzymes are now back to normal but I still am testing positive for “core AB Total” and my tests are showing low immunity (Low Hep B surface quantity). I was vaccinated as a baby.

Upon speaking to my doctor I became more confused and I’m not sure if I have Hep B or not. I was told the “total” test can indicate a past exposure but I do not have a current infection. However, my doctor said Hep B can lay dormant for years sometimes and I need to get tested yearly to make sure I don’t have it. I was told there is no single test to see if I have it. I was told I don’t need to do anything about it for now. I have two questions:

  1. I had the understanding that if I had a previous infection that was resolved I would have immunity. Shouldn’t my immunity levels be higher if that’s the case?

  2. I have never heard of Hep B “laying dormant”. I thought I either would have it or I wouldn’t after being exposed. Does this mean I have Hepatitis B and need to be mindful of passing it along and my future health? Or is it likely I don’t have it?

Thanks in advance!

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Now I am even more confused than before…
The test I got back says it’s
“Hepatitis B Virus Surface Antigen, Conf”
Result was “non confirmed”

  • Result Comment
  • Hepatitis B surface antigen (HBsAg) failed to neutralize using
  • anti-HBs. This specimen is therefore NEGATIVE for HBsAg.

Hepatitis B Surface Ag w/ Reflex to Conf

  • Result Comment
  • The HBsAg screen is repeatedly reactive at a low level. Refer to
  • the HBsAg Confirmation test for additional detail.
    So what does this mean?
    I had the same tests done in December with the same exact results.