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Anti Hepatitis B Core Antibody (AHBC) - IGM
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Anti-HBc IgM detects IgM-class antibodies against the core antigen of the Hepatitis B virus (HBcAg). This test is used to diagnose acute or recent Hepatitis B infection
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Anti Hepatitis B Core Antibody (AHBC) - IGM
- Why is it done?
- Detects IgM antibodies against hepatitis B core antigen (HBcAg), which appear early during acute hepatitis B infection
- Diagnosing acute hepatitis B infection to differentiate it from chronic hepatitis B or past infection
- Evaluating patients presenting with acute hepatitis symptoms (jaundice, fatigue, abdominal pain, dark urine)
- Screening blood and organ donors to prevent transmission of acute HBV infection
- Monitoring healthcare workers and individuals with occupational exposure after potential needle-stick injuries
- Resolving serological profiles in patients with positive HBsAg and anti-HBc to determine timing of infection
- Typically performed during the early symptomatic phase of hepatitis B infection (appears within first 1-2 weeks)
- Normal Range
- Normal/Negative Result: Negative or Not Detected (typically reported as '<0.8 IMUM/mL' or 'Not Reactive')
- Units of Measurement: IMUM/mL (International Mail Unit per milliliter) or S/CO ratio (Sample to Cutoff ratio)
- Positive Result: ≥0.8 IMUM/mL or Reactive (indicates presence of IgM antibodies against HBcAg)
- Interpretation Guide:
- Negative: Absence of IgM antibodies; indicates no acute HBV infection (may indicate immunity from vaccination, chronic infection without acute exacerbation, or past resolved infection)
- Positive: Presence of IgM antibodies; indicates acute or very recent HBV infection, typically within 1-6 months of exposure
- Borderline/Equivocal Results: May indicate early acute infection or false positive; repeat testing after 1-2 weeks is recommended
- Interpretation
- Positive Anti-HBc IgM (Reactive):
- Highly suggestive of acute hepatitis B infection; IgM antibodies typically present within 1-2 weeks of HBsAg appearance and usually persist for 3-6 months
- When combined with positive HBsAg and positive HBeAg, indicates acute HBV infection during the window period
- Can occasionally be present in chronic HBV carriers experiencing acute exacerbation
- Negative Anti-HBc IgM (Non-Reactive):
- Excludes acute hepatitis B infection; indicates chronic HBV infection, past resolved infection with immunity, or vaccination-induced immunity
- When negative with positive anti-HBc IgG and positive anti-HBs, indicates resolved past infection with immunity
- Clinical Significance in Serological Patterns:
- HBsAg+, Anti-HBc IgM+: Acute HBV infection (most informative)
- HBsAg+, Anti-HBc IgM-: Chronic HBV infection or late acute phase
- Anti-HBc+, Anti-HBc IgM-: Past HBV infection or chronic infection (with or without immunity)
- Factors Affecting Results:
- Timing of testing during infection cycle (earlier tests more likely positive)
- Laboratory assay sensitivity and specificity (varies by methodology)
- Immunocompromised patients may have delayed or absent antibody response
- False positives can occur with certain autoimmune conditions or other infections
- Associated Organs
- Primary Organ System:
- Liver - Hepatitis B virus directly infects hepatocytes, causing hepatic inflammation and injury
- Diseases and Conditions Associated with Positive Results:
- Acute hepatitis B: Characterized by sudden onset of jaundice, fatigue, dark urine, pale stools, abdominal discomfort, and elevated liver enzymes
- Fulminant hepatic failure: Severe acute infection leading to rapid loss of hepatic synthetic function
- Acute exacerbation of chronic hepatitis B: Flare-up in chronic HBV carriers with significant ALT elevation
- Hepatitis with coinfection: HBV concurrent with HAV, HCV, or HDV infections
- Potential Complications:
- Hepatic necrosis and cirrhosis development if infection progresses chronically
- Hepatocellular carcinoma (HCC) risk increases significantly with chronic HBV
- Portal hypertension with esophageal varices and bleeding risk
- Hepatic encephalopathy and liver failure requiring transplantation
- Extrahepatic manifestations: Glomerulonephritis, polyarteritis nodosa, cryoglobulinemia
- Follow-up Tests
- Recommended Confirmatory and Related Tests:
- HBsAg (Hepatitis B Surface Antigen) - Primary marker for HBV infection; usually positive before anti-HBc IgM appears
- Anti-HBc total (Total Core Antibody) - Distinguishes HBV infection from vaccination; remains positive lifetime
- HBeAg (Hepatitis B e Antigen) - Indicates high viral replication and infectivity during acute infection
- Anti-HBe (Hepatitis B e Antibody) - Appears as viral replication decreases during recovery phase
- Anti-HBs (Hepatitis B Surface Antibody) - Develops after HBsAg clearance; indicates immunity and recovery
- HBV DNA (Viral Load) - Quantifies circulating HBV; most sensitive marker of active replication
- Liver Function Tests:
- ALT (Alanine Aminotransferase) - Elevated in acute HBV; markedly increased (often >1000 IU/L)
- AST (Aspartate Aminotransferase) - Also markedly elevated; AST/ALT ratio typically <1 in acute HBV
- Bilirubin (Total and Direct) - Elevated in jaundice phase; correlates with severity
- Albumin and Prothrombin Time (PT/INR) - Assess hepatic synthetic function
- Additional Testing if Indicated:
- HAV, HCV, HDV serology - Screen for concurrent viral hepatitis coinfections
- HIV testing - Important given shared transmission routes; impacts prognosis
- Abdominal ultrasound or CT - Assess liver size, echogenicity, and screen for cirrhosis if chronic
- Liver biopsy - May be considered for chronic HBV to assess fibrosis stage
- Monitoring Frequency:
- Acute HBV: Repeat anti-HBc IgM and HBsAg every 1-2 weeks initially to document clearance trajectory
- Recovery phase: Monthly LFTs and HBsAg/Anti-HBs until anti-HBs becomes positive
- Chronic HBV development: 3-6 month monitoring of HBV DNA, HBeAg status, and LFTs; annual ultrasound for cirrhosis surveillance
- Fasting Required?
- Fasting Requirement: NO - Fasting is not required for anti-HBc IgM testing
- Sample Collection:
- Blood sample obtained via venipuncture into standard serum separator tube
- No special preparation or dietary restrictions needed
- Can be collected at any time of day regardless of meal timing
- Medications:
- No medications need to be discontinued prior to testing
- Continue all regular medications as prescribed
- Antiviral therapy (if already started) does not invalidate results but may affect kinetics of antibody development
- Other Patient Preparation:
- Inform healthcare provider of recent potential HBV exposure or risk factors
- Report current symptoms (jaundice, fatigue, fever, abdominal pain, dark urine)
- Disclose any recent vaccinations or immunoglobulin treatments
- No hydration or fluid intake restrictions required
- Wear loose-fitting sleeves for easier venipuncture access
How our test process works!
