Is it possible to have HBsAg POSITIVE but Anti-HBc Total NEGATIVE?

Does somebody who is surface antigen positive (HBsAg positive) always have Anti-HBc Total positive also? Or can they also be Anti-HBc total negative?

Thanks

[stef2011]

hbcab igm is always negative on cronic (chronic) hbv and if you mean hbcab igg negative it doens tmake a big difference because even if positive the titer is very low

what really matters on hbv infection is:
hbsag quant in iu/ml (i bet this is inversely correlated with nagalase enzyms)
hbvdna

all the rest is not very important since immune response is suppressed by hbsag and there are very low/undetectables antibodies anyway

[JackJackson]

Thanks for that but I didn't quite understand. Is it possible for a patient to be HBsAg POSITIVE but Anti-HBc Total NEGATIVE?

[stef2011]

there are cases in hiv pos/aids patients with a lot of hbv mutants without hbcab and/or without hbsag too, that's due to many mutations of hbv with a very weak immune system

in any case variants are possible in hiv neg too, hbsag negative hbv is more common than hbcab negative

if you google hbcab negative hepatitis b you might find some articles