QUIZ: Interpreting Hepatitis B Serology

 

🧪 Quiz: Interpreting Hepatitis B Serology

Test your understanding of Hepatitis B serology with these five clinical scenarios. Can you apply serological markers to real-world cases?

1. A 26-year-old male presents with fatigue, nausea, and jaundice for the past two weeks. He has dark urine and right upper quadrant pain. Blood tests reveal:
HBsAg: Positive
IgM anti-HBc: Positive
HBeAg: Positive
HBV DNA: High (>10⁷ IU/mL)

What is the most likely interpretation?
A. Recent HBV vaccination
B. Acute HBV infection with high replication
C. Resolved HBV infection with immunity
D. Chronic HBV infection with immune escape
E. HBsAg-negative occult HBV infection

2. A 50-year-old male, previously diagnosed with HBV infection 12 years ago, presents for routine follow-up. He has no symptoms, but labs show:
HBsAg: Positive (>6 months)
IgG anti-HBc: Positive
HBeAg: Negative
Anti-HBe: Positive
HBV DNA: Low

Which statement best describes his infection status?
A. Acute HBV infection, highly replicative
B. Chronic HBV infection, immune control phase
C. Resolved HBV infection with lasting immunity
D. Recent HBV exposure but not actively infected
E. Occult HBV infection with low viral load

3. A 38-year-old female undergoes pre-employment screening for healthcare work. She is asymptomatic, and labs reveal:
HBsAg: Negative
Anti-HBs: Positive
IgG anti-HBc: Positive
HBV DNA: Undetectable

What is the best interpretation?
A. Acute HBV infection with high replication
B. Chronic HBV infection requiring antiviral treatment
C. Resolved HBV infection with natural immunity
D. HBV vaccine response without prior infection
E. Occult HBV infection, requiring further testing

4. A 22-year-old medical student checks HBV immunity before starting clinical rotations. Blood tests show:
HBsAg: Negative
Anti-HBs: Positive
Anti-HBc: Negative

Which statement is correct?
A. Previous HBV infection with successful immune clearance
B. Chronic HBV carrier requiring lifelong monitoring
C. HBV vaccination-induced immunity, no prior infection
D. Window period infection, follow-up required
E. Acute HBV infection requiring urgent treatment

5. A 65-year-old male, preparing for surgery, undergoes preoperative HBV screening. He has no symptoms and no known history of hepatitis. His labs show:
HBsAg: Negative
Anti-HBs: Negative
Anti-HBc: Positive (IgG)

What is the next best step?
A. Start immediate antiviral therapy for chronic HBV
B. Check HBV DNA to rule out occult HBV infection
C. HBV immunity confirmed, no further action needed
D. Repeat serology in six months to confirm clearance
E. Diagnose acute HBV infection and monitor ALT

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