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The Hepatitis B Core Antigen-Total Antibodies (Anti-HBc-Total) test measures the presence of antibodies against the core antigen of the Hepatitis B virus (HBV). The core antigen is a protein found inside the virus, and antibodies against it are produced by the immune system when the body is exposed to the virus.

Key Points about the Test:

• Total Anti-HBc includes both IgM and IgG antibodies. These antibodies appear at different stages of the infection:
  • IgM Anti-HBc: Typically present during acute infection or early in the course of the disease.
  • IgG Anti-HBc: Appears later, typically in the chronic phase or after the acute phase has passed, and can persist for years, even after the infection resolves.

Purpose of the Anti-HBc-Total Test:

• Identify past or current infection: This test helps determine if a person has ever been infected with the Hepatitis B virus. The presence of Anti-HBc-Total suggests that a person has been exposed to HBV, either in the past or currently.

• Assess immune status: A positive result can indicate either acute, chronic, or resolved infection depending on other factors (like the presence of HBsAg, the Hepatitis B surface antigen).

• Diagnose chronic infection or exposure: The test is useful in diagnosing chronic Hepatitis B or distinguishing between those who are infected and those who have been vaccinated (as the vaccinated person would not have Anti-HBc antibodies, only the Anti-HBs surface antibodies).

Interpretation of Results:

• Positive Anti-HBc-Total: Indicates exposure to HBV, either in the past or present. Further tests (like HBsAg or HBV DNA PCR) can confirm whether the infection is acute or chronic.
• Negative Anti-HBc-Total: Indicates no exposure to Hepatitis B, or the person has been vaccinated, assuming they also have a negative Anti-HBs test.

Why it’s done:

• Screening for past infection in people with a history of possible exposure to Hepatitis B (e.g., through unprotected sex, needle use, or from an infected mother).
• Confirming Hepatitis B status in people with unexplained liver issues, or as part of a routine checkup, especially in high-risk groups.

This test is often part of a broader panel of Hepatitis B tests, which can include Hepatitis B Surface Antigen (HBsAg), Hepatitis B Surface Antibody (Anti-HBs), and Hepatitis B Viral Load (HBV DNA) for more comprehensive diagnosis and understanding of the infection stage.