After completing the hepatitis B vaccination series in the absence of prior infection, which serologic marker would you expect to be negative?

After completing the hepatitis B vaccination series in the absence of prior infection, which serologic marker would you expect to be negative?

• A. anti-HBs positive
• B. anti-HBe negative
• C. anti-HBc negative
• D. all of the above

Answer: (C)

Vaccination introduces only the hepatitis B surface antigen, which stimulates production of anti-HBs antibodies. It does not include the core antigen, so anti-HBc antibodies aren’t formed. In someone who completed the vaccine series with no prior infection, the core antibody would be negative, even though anti-HBs is positive from the vaccine. Anti-HBe would also typically be negative since there’s no viral replication to drive its production, but the hallmark negative marker that differentiates vaccination-induced immunity from prior infection is anti-HBc.

Vaccination introduces only the hepatitis B surface antigen, which stimulates production of anti-HBs antibodies. It does not include the core antigen, so anti-HBc antibodies aren’t formed. In someone who completed the vaccine series with no prior infection, the core antibody would be negative, even though anti-HBs is positive from the vaccine. Anti-HBe would also typically be negative since there’s no viral replication to drive its production, but the hallmark negative marker that differentiates vaccination-induced immunity from prior infection is anti-HBc.