Interpretation of results of hepatitis B serologic tests

• 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).
• Initially, the 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.

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