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HBcAb Total

Hepatitis Biomarker

Sample Needed

Collection Type: Blood

Body System

Related System: Hepatitis

Overview

HBcAb Total (total antibody to hepatitis B core antigen, anti-HBc Total) is a serologic marker that detects both IgM and IgG antibodies directed against the core protein of hepatitis B virus (HBV). The test does not distinguish between recent and past infection by itself (IgM vs IgG), but a positive result shows prior exposure to HBV—either acute, resolving, or remote/chronic infection. It is used alongside HBsAg and anti-HBs to determine infection status. Symptoms prompting testing include jaundice, fatigue, abdominal pain, dark urine, elevated liver enzymes, or known exposure (needlestick, sexual contact). Prevalence varies by age, geography, and risk behaviors; older adults or people from endemic areas are more likely to be positive.

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Test Preparation

No special preparation is required

Why Do I Need This Test

Profile: Hepatitis panel / HBV serology.
Symptoms: Jaundice, malaise, anorexia, abdominal pain, dark urine, elevated ALT/AST, known exposure.
Diagnoses/monitoring: Detects prior or current HBV infection; helps distinguish acute, window period, resolved, or chronic infection when combined with other markers.
Reasons for abnormal (positive) result: Acute or past HBV infection, chronic carrier state, or false-positive assay.
Biological meaning: Positive indicates immune response to HBV core antigen (past or current exposure); IgM component suggests recent/acute infection.
Behaviors/family history: Unprotected sex, IV drug use, blood transfusion, household contact with HBV, travel to endemic areas, family history of hepatitis B increase testing need.

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Understanding Test Results

Non-reactive (S/CO 1.0): No detectable anti-HBc; suggests no prior exposure to HBV (if testing reliable and not during very early window period).
Low likelihood of past or current infection.
Reactive/Positive (S/CO 1.0): Indicates prior exposure to HBV.
Interpretation depends on other markers: Anti-HBc total positive HBsAg positive: current active infection (acute or chronic).
Anti-HBc total positive with IgM anti-HBc positive: recent/acute infection (usually within past ~6 months).
Anti-HBc total positive anti-HBs positive, HBsAg negative: resolved past infection with immunity.
Isolated anti-HBc total positive (HBsAg negative, anti-HBs negative): may represent the window period of acute infection, remote past infection with waned anti-HBs, chronic low-level infection, or false-positive—requires repeat testing, IgM testing, HBV DNA or clinical correlation.
High-risk implications: A positive anti-HBc total implies risk of reactivation with immunosuppression and warrants baseline screening before chemotherapy or immunosuppressive therapy.
False positives can occur (low prevalence settings, autoimmune disease); confirmatory testing (repeat serology, HBV DNA, or IgM-specific assay) is recommended when results are unexpected.

Normal Range

Non-reactive (Negative) qualitative result (no units); many assays report signal-to-cutoff (S/CO) 1.0 as non-reactive.

FAQs

Q: What is HBcAb total?

A: HBcAb total is the total hepatitis B core antibody that detects both IgM and IgG against the core antigen. Its presence indicates past or current hepatitis B exposure. A positive IgM component suggests recent/acute infection; a positive total with negative HBsAg but positive anti‑HBs generally indicates recovery and immunity. Interpretation requires correlation with HBsAg, anti‑HBs and clinical context.

Q: What does HBcAb total non reactive mean?

A: HBcAb (total) non‑reactive means no hepatitis B core antibodies were detected, suggesting you likely have not had a past or current hepatitis B infection. It does not indicate vaccination immunity (vaccines do not produce core antibodies). Very recent infection or immunosuppression can cause false negatives, so clinicians often check HBsAg and anti‑HBs or repeat testing after the window period.

Q: What does hepatitis AB total mean?

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Q: What is the normal range for hepatitis B core total?

A: The normal result for hepatitis B core total (anti‑HBc total) is negative (non‑reactive), meaning no detectable core antibodies. Many labs use a cut‑off index: <1.0 (non‑reactive) is normal; ≥1.0 (reactive) indicates past or current infection. A positive anti‑HBc can persist after infection; IgM anti‑HBc suggests recent/acute infection. Correlate with HBsAg and anti‑HBs.

Q: What HBV DNA level is high?

A: HBV DNA is measured in IU/mL. Common clinical cutoffs: <2,000 IU/mL is low; 2,000–20,000 IU/mL is intermediate/concern; >20,000 IU/mL is considered high and usually indicates active replication—often prompting antiviral treatment if ALT is raised or fibrosis is present. Very high levels (e.g., >200,000 IU/mL) reflect very active replication and greater transmission risk.

Q: Does HBcAb Total stay positive for life?

A: Total anti-HBc (HBcAb Total) detects both IgM and IgG to hepatitis B core antigen. After natural infection, IgG anti-HBc usually persists for life, so the total antibody typically remains positive even after recovery or clearance of HBsAg. Rarely, levels may wane in immunocompromised people or produce false positives; vaccination does not induce anti-HBc.