Serology of Hepatitis B

In the interpretation of results of hepatitis B serologic tests, the following facts should be considered:

during the incubation period (i.e., before the onset of clinical manifestations) HbsAg, HbeAg, and HBV DNA become detectable in the serum.

At the onset of clinical symptoms (e.g., jaundice), an increase in the serum transaminases antibodies occurs and antibodies to HBc become detectable (HBc antibodies).

HBc antibodies are IgM and thereafter IgG; these latter antibodies persist for years.
HBs antibodies become detectable late in convalescence.
A rise in HBs antibodies in combination with a loss of HbsAg, HbeAg, and HBV DNA indicate the presence of immunity to HBV.
HbeAg and HBV DNA are markers of active viral replication and thus indicate high infectivity.
The loss of HbeAg and appearance of anti-HbeAb indicates a less infective stage.