Hepatitis B Core Antibody, IgM

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Turnaround Time: 1 - 2 days
CPT Code:


Test Type: 1 mL Serum or plasma
Stability Time:



Room temperature

14 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Reference Range:



IgM antibody to hepatitis B core antigen is a reliable marker for acute disease for a hepatitis B viral infection. At times this marker is the only one demonstrated for the diagnosis of a hepatitis B viral infection.

Anti-HBc appears 5 to 14 days after HBe antigen and can be found shortly before HBsAg is no longer detectable. It may be negative in 9% of patients with acute hepatitis B in the first two weeks of illness, and should be repeated if clinically warranted. Anti-HBc and anti-HBe may be the only markers detectable in some patients at the time of presentation. The period between the disappearance of HBsAg and the appearance of HBsAb is often called the “core window.” Anti-HBc persists for months to years after resolution of acute hepatitis B, and also persists in cases of chronic infection; however, the demonstration of IgM-specific HBcAb is evidence that the patient is in an acute infection. Conversely, the absence of IgM core antibody in a patient with long-term B surface antigenemia suggests chronic hepatitis B viral infection. In addition, the absence of IgM core antibody with persistent B surface antigen and symptoms of acute hepatitis suggests acute non-A, non-B hepatitis or superinfection with δ hepatitis. See figure.

AuBuchon JP, Sandler SG, Fang CT, Dodd RY. American Red Cross experience with routine testing for hepatitis B core antibody. Transfusion. 1989 Mar-Apr; 29(3):230-232. PubMed 2493695

Chambers LA, Popovsky MA. Decrease in reported posttransfusion hepatitis. Contributions of donor screening for alanine aminotransferase and antibodies to hepatitis B core antigen and changes in the general population. Arch Intern Med. 1991 Dec; 151(12):2445-2448. PubMed 1747001

Edwards MS. Hepatitis B serology--help in interpretation. Pediatr Clin North Am. 1988 Jun; 35(3):503-515. PubMed 3287312

Gupta S, Govindarajan S, Fong TL, Redeker AG. Spontaneous reactivation in chronic hepatitis B: patterns and natural history. J Clin Gastroenterol. 1990 Oct; 12(5):562-568. PubMed 2230000

Lee HS, Vyas GN. Diagnosis of viral hepatitis. Clin Lab Med. 1987 Dec; 7(4):741-757 (review). PubMed 3319367

Mushahwar IK, Dienstag JL, Polesky HF, McGrath LC, Decker RH, Overby LR. Interpretation of various serological profiles of hepatitis B virus infection. Am J Clin Pathol. 1981 Dec; 76(6):773-777. PubMed 7315794

Collection Details:

Patient Preparation:

Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Collection Instructions:

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube.

If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube.

Room temperature.