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A 48 yo waitress presents to a physician w/ malaise, loss of appetite, nausea, moderate fever and jaundice. Lab tests reveal a marked increase in serum transaminases. Serology for hepatitis viruses is performed and indicates positive results for the presence of HBsAg, HBc IgM antibody, and HCV antibody. Antibosy tests for HbsAb and HAV are negative. The results indicate:
a. A dual infection of HBV and HAV
b. Chronic Hep A infection
c. Chronic Hep B infection
d. Hep C infection
e. The presence of an acute HBV infection
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I go for e. HCV antibody?---previous infection?
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Should be e. IgM HBVc indicates a recent infection. IgM HBc---> acute IgG HBc----> chronic
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i find this question a little awkward, the way it's constructed......but yeah, e is right 
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isn't it the presence of HBsAg that determines your chronic-state status?
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Persistence of HBs Ag longer than 6 month determines chronic state,HBc IgM indicate that it's acute infection.HCV Ab?- previous infection put as distraction?
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Yes,,, I agree, the answer should be e....
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answer is e......in acute HBV infection they can show + for anti HCV
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Answer is defnitely c:
Reason: Always remember HCV infection remains in the body permenantly, in the form of floating RNAs.
Although the question doesn't describe the duration of illness for Hepatitis B, it is clear from the description that................1) HBsAg- is present during carrier state over more than 6 months;
2) HBc IgM antibody is seen- which could be seen in carrier or chronic state, remembner your judgement of the question is the most inportant step to answer a question correctly. If you have short listed answer choices i.e. c, d, e then you HAVE TO ELIMINATE d and e, because it is neither acute infection for hep.b nor it is Hep C infection.
I hope it answers your question.
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I don't agree with you, usmle_girl.
HBc IgM is present in acute infection.
HBc IgG is seen in chronic infection.
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