Hepatitis B Serologic Tests

Interpretation of Results

Susceptible (Not Immune)

Patients with anti-HBs levels <10 IU/L are considered not protected against hepatitis B and should be offered immunization. We offer hepatitis B vaccination in susceptible refugees because these patients are likely to go back to their country of origin in the future.

Immune due to Previous Infection or Vaccination

For patients with anti-HBs levels >10 IU/L, no further management is recommended.

Isolated Anti-HBc Positivity

In cases of isolated anti-HBc positivity (HBsAg neg, anti-HBc pos, anti-HBs <10IU/L), there are 4 diagnostic possibilities:

1. Resolved infection (with waning anti-HBs levels)

2. False-positive anti-HBc (susceptible)

3. Occult hepatitis B infection with undetectable HBsAg

4. Resolving acute infection

Chronic Hepatitis B (HBsAg positive)

For chronic hepatitis B, follow these initial steps:

1. Report to Communicable Disease Unit

2. Appropriate post-diagnosis counselling

3. Screen contacts

4. Offer vaccination to contacts

5. Order initial blood tests (ALT, HBeAg, anti-HBe, HBV DNA)

6. Begin hepatocellular carcinoma screening

7. Hepatology referral

Follow-up blood tests should be done every 6 months.