Hepatitis B serology: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Hepatitis B serology

Sample item

A 40-year-old nurse is screened and the results are HBsAg negative, anti-HBs positive, total anti-HBc positive, anti-HBc IgM negative and HBeAg negative. How should these results be interpreted?

AEarly acute infection in the window periodBChronic hepatitis B with active replicationCRecovered past infection with natural immunityDImmunity from vaccination only

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Recovered past infection with natural immunity

Anti-HBc appears after natural infection and is not produced by the recombinant vaccine, which contains only HBsAg. Loss of HBsAg with anti-HBs and IgG anti-HBc indicates recovery. Negative anti-HBc IgM excludes recent acute infection.

Option by option

A. Early acute infection in the window period
The window period shows HBsAg negative and anti-HBs negative with anti-HBc IgM positive.
B. Chronic hepatitis B with active replication
Chronic infection requires HBsAg persisting beyond six months, which is absent here.
C. Recovered past infection with natural immunity (correct)
Correct. Anti-HBs together with anti-HBc IgG and no HBsAg shows resolved infection.
D. Immunity from vaccination only
Vaccination gives anti-HBs alone, with anti-HBc negative.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Recovered past infection with natural immunity. Anti-HBc appears after natural infection and is not produced by the recombinant vaccine, which contains only HBsAg.

Why is "Early acute infection in the window period" not the answer?

The window period shows HBsAg negative and anti-HBs negative with anti-HBc IgM positive.

Why is "Chronic hepatitis B with active replication" not the answer?

Chronic infection requires HBsAg persisting beyond six months, which is absent here.

Why is "Immunity from vaccination only" not the answer?

Vaccination gives anti-HBs alone, with anti-HBc negative.

What concept does this question test?

It tests Hepatitis B serology in Pathology. Loss of HBsAg with anti-HBs and IgG anti-HBc indicates recovery. Negative anti-HBc IgM excludes recent acute infection.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatitis B serology?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.