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Some time ago I was rejected as donor and received following rejection letter:

Just wanted to inform you that there was a positive infectious disease result for Hepatitis B. Unfortunately, we cannot take donors into the program with a positive Hepatitis B test result due to the inventory possibly being compromised.

And the following test results were attached to the rejection letter:

Hepatitis Bc IgM Ab: NON-REACTIVE (Anti-HBc IgM)

Hepatitis Bs Ag: NON-REACTIVE (HBsAg)

Hepatitis Bc Ab: REACTIVE (HBcAb)

Obviously, I don't want to be a donor, if I pose risk to someone else. So I am fine with their judgment, if it is in best interest of others.

However, now I am curious, especially after I found this CDC website and I am trying to understand under which category I fall under.

My understanding is that I fall under "Immune due to natural infection" and that it is actually impossible for me to infect others via sexual intercourse or if someone else uses my blood?

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    EXCELLENT question, and welcome!
    – DoctorWhom
    Commented Oct 26, 2017 at 3:15
  • Did you copy your results correctly? The one reactive test, HBcAb, doesn't appear in the link you provided.
    – Carey Gregory ♦
    Commented Oct 26, 2017 at 5:11
  • @CareyGregory I just double checked everything and yes, I have copied everything correctly. Could "HBcAb" be the same thing as "anti-HBc" that does show up in the table?
    – user19123129129
    Commented Oct 26, 2017 at 17:57

1 Answer 1

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The Hepatitis B core antibody test is positive for IgG but negative for IgM indicating that you had the hepatitis B infection a while ago. The negative hepatitis B surface antigen test means that they are not detecting the hepatitis B in your blood when testing for the virus surface antigen. This means you've successfully cleared the infection to a very low level. You don't mention the hepatitis B surface antibody levels which are usually used to determine if you're now immune eg. after a series of hepatitis B vaccinations.

This doesn't mean you don't have the virus in your system. Immunosuppressants such as methotrexate and TNF inhibitors could still potentially reactivate the hepatitis B infection. So, you'd want to measure the HBV DNA viral load and then track that serially to see if such treatment causes a reactivation.

https://www.ncbi.nlm.nih.gov/pubmed/24805974

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  • Indeed, it seems that donor clinic did not do HBsAb (Hepatitis B Surface AntiBody test). However, I just stumbled across HBsAb tests I did long time ago with my general doctor and I have had HBsAb positive there. I guess this HBsAb positive proves that I am actually naturally immune, but the donor clinic does not care about HBsAb because they just don't want to take any risk?
    – user19123129129
    Commented Oct 26, 2017 at 18:18
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    Because it's not relevant to them. They have already established you have been infected.
    – Graham Chiu
    Commented Oct 26, 2017 at 19:50

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