Serologic and Virologic Markers of Hepatitis B Virus Infection
This answer is correct. This serologic profile is consistent with acute HBV infection, but it is also consistent with chronic HBV infection. In the case presented here, several factors—the recent epidemiologic exposure, the negative hepatitis B serologic test 2 years prior, and the markedly elevated hepatic aminotransferase levels—suggest that this woman has acute HBV infection. Patients with acute HBV infection typically have high titers of viral antigens (HBsAg and HBeAg) and absence of anti-HBs and anti-HBe. Patients with chronic infection usually have a similar profile, but may have negative HBeAg with positive anti-HBe. A positive total anti-HBc is present with both acute and chronic HBV infection. To differentiate acute versus chronic infection, an IgM anti-HBc should be ordered, since this test is positive with acute HBV infection, but not chronic HBV infection.