Question

A 42-year-old woman IV drug user presents with vague symptoms of fatigue, aches, pains, and nausea. Recently, she appeared jaundiced for a few days; however, she no longer does. Preliminary blood tests indicate the patient does not have hepatitis B. However, the tests could be wrong, as she may be in the window period. If she were in the window period, what would be the only evidence of hepatitis B infection?

1 Anti-HBc
2 HBsAg
3 HBcAg
4 HBeAg
5 Anti-HBs

Answer 1

During the window period for hepatitis B, the only evidence of infection would be the presence of Anti-HBc, the IgM antibody to hepatitis B core antigen, as other markers like HBsAg and anti-HBs may not be detectable.

Step-by-step explanation:

If a 42-year-old woman who is an intravenous drug user presents with symptoms of fatigue, aches, pains, nausea, and had recently appeared jaundiced, and preliminary tests indicate she does not have hepatitis B, but could be in the window period, the only evidence of hepatitis B infection at this stage would be the presence of the Anti-HBc (IgM antibody to hepatitis B core antigen).

This occurs because, during the window period, the HBsAg (hepatitis B surface antigen) may no longer be detectable and the anti-HBs antibodies (antibodies to hepatitis B surface antigen) may not have appeared yet.

The window period refers to the time after infection and before seroconversion that is detectable on standard tests. In this case, Anti-HBc is the marker that indicates a recent or ongoing hepatitis B infection, even when other markers may not be present.

Answer 2

During the window period of a hepatitis B infection, the only reliable evidence of infection is typically the presence of hepatitis B core antibodies (Anti-HBc) (option 1).

Step-by-step explanation:

Patients in the window period of a hepatitis B infection may have negative results for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg), as well as undetectable levels of hepatitis B surface antibodies (Anti-HBs). During this time, the only reliable evidence of hepatitis B infection often comes from the presence of hepatitis B core antibodies (Anti-HBc). These antibodies form in response to a core protein of the virus and can be detected during acute or chronic infection. In the scenario described where a patient presents with fatigue, aches, pains, and nausea, and a history of IV drug use, testing for Anti-HBc would be essential to rule out hepatitis B, particularly during the window period when other markers might not be present.

Hence, the answer is option 1.