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26 years
My Hepatitis B c Ab COI level is a 1.940 , is it a sign of an infection? i have been vaccinated for hepatitis B Hepatitis B s Ag is non reactive at level of 0.46 Thank you
Sep 30, 2014

Dr. Zakia Dimassi Pediatrics
Hepatitis B core antibodies (anti-HBc Ab) appear shortly after the onset of symptoms of hepatitis B infection and soon after the appearance of hepatitis B surface antigen (HBsAg). Initially, anti-HBc Ab consist almost entirely of the IgM class, which dominate during the acute phase of the infection, followed by appearance of anti-HBc IgG, for which there is no commercial diagnostic assay.

The anti-HBc total antibodies test, which detects both IgM and IgG antibodies, and the test for anti-HBc IgM antibodies may be the only markers of a recent hepatitis B infection detectable in the "window period." The window period begins with the HBsAg getting cleared from the circulation and ends with the appearance of antibodies to hepatitis B surface antigen (anti-HBs Ab). Anti-HBc total Ab may be the only serologic marker remaining years after exposure to hepatitis B.
In your case, there are two possibilities:
1- Immunity due to hepatitis B vaccination (more likely): HBsAg negative, anti-HBc negative, and anti-HBs positive
OR
2- Immunity due to natural infection (HBsAg negative, anti-HBc positive, anti-HBs positive)
 •