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An acute hepatitis B infection follows a relatively long incubation period - from 1 to 4 months. It can take up to six months, however, for a person's serology to reflect whether they have recovered from an acute infection or have become chronically infected.

The following graphic from the Centers for Disease Control and Prevention (CDC) represents the typical course of an acute hepatitis B infection.

Source: Centers for Disease Control

CDC Notes About HBV Infections

Serologic markers of HBV infection vary depending on whether the infection is acute or chronic.

  • HBsAg is the first serologic marker to appear following acute infection, which can be detected as early as 1 or 2 weeks and as late as 11 or 12 weeks (mode, 30-60 days) after exposure to HBV.
  • HBsAg is no longer detectable in serum after an average period of about 3 months in persons who have recovered.   
  • HBeAg is generally detectable in patients with acute infection; the presence of HBeAg in serum correlates with higher titers of HBV and greater infectivity.
  • A diagnosis of acute HBV infection can be made on the basis of the detection of IgM anti-HBc in serum; IgM anti-HBc is generally detectable at the time of clinical onset and declines to sub-detectable levels within 6 months.
  • IgG anti-HBc persists indefinitely as a marker of past infection.
  • HBsAb (or Anti-HBs) becomes detectable during convalescence after the disappearance of HBsAg in patients who do not progress to chronic infection. The presence of anti-HBs following acute infection generally indicates recovery and immunity from re-infection.

Page last reviewed March 2014

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