Given anti-HBc and HBsAg and HBeAg reactive with anti-HBs nonreactive, what is the most likely interpretation?

• A. Acute HAV infection
• B. Acute HBV infection
• C. Chronic HBV infection
• D. Immunity to HBV from past infection

Answer: (C)

This pattern reflects an ongoing HBV infection with high viral replication and no protective immunity. HBsAg being positive indicates current Hepatitis B infection. The presence of HBeAg shows active viral replication, meaning the virus is producing large amounts and the person is highly infectious. Anti-HBc being reactive confirms exposure to HBV, and the absence of anti-HBs means there is no immunity from vaccination or recovery. In acute HBV, you would typically see anti-HBc IgM, whereas anti-HBc here is consistent with the IgG form seen in chronic infection. Therefore the combination points to chronic HBV infection with high infectivity. Immunity from past infection would usually have anti-HBs present, which is not the case here. An acute HBV infection pattern would differ in the anti-HBc signaling and timing of HBsAg/HBeAg changes.