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Interpretation of HBsAg & Hep B CoreAb, IgM
Mar 28, 2005

I received 3 injections of the Hep B vaccine several years ago.I recently was notified of the following results. What do the test results indicate and what follow up tests or referral, if any, should I ask for. I wan especially concerned about how contagious I am. I am not confident that my physician has experience in this area.

Here are the results of the Hepatitis Panel (4) Hep A Ab, Igm -Negative HBsAg Screen -Negative Hep B Core Ab, Igm -Positive Hep C Virus Ab -Negative

Response from Dr. McGovern

This is a puzzling case.

If you received immunizations in the past, you should have only hepatitis B surface antibody present.

Instead you have IgM core Ab present. If your liver function tests are normal and you do not have risks for hepatitis B, I would simply repeat the blood tests.

If you have a new risk of hepatitis B and your liver function tests are abnormal, your IgM is consistent with acute hepatitis B. I would consider you infectious; your contacts then also need immunization right away.

Please discuss this further with your health care provider, since patients can get hepatitis B if they have not been significantly protected by vaccine (ie, they didn't develop protective antibody). If they do get hepatitis B after immunization though, these cases tend to be very mild. You will need follow-up liver function testing and hepatitis B panel to determine that you become core antibody IgG positive and surface antibody positive.

Dr. McGovern



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