P. GREGORY FOUTCH, D.O.; WILLIAM D. CAREY, M.D.; EDWARD TABOR, M.D.; A. J. CIANFLOCCO, M.D.; SATORU NAKAMOTO, M.D.; LINDA A. SMALLWOOD, Ph.D.; ROBERT J. GERETY, M.D., Ph.D.
Both hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs) were found in 13 patients. Nine patients had HBsAg subtype ad, and 7 had anti-HBs monotypic subtype anti-y. Nine patients had HBsAg before detectable levels of anti-HBs were present. Of the 6 patients whose serum contained subtypes of both HBsAg and anti-HBs, 4 had HBsAg before development of the monotypic antibody. All patients have remained positive for HBsAg and anti-HBs (mean duration, 55.5 weeks). Nine patients were positive for HBeAg, and 7 had renal disease. Six of these seven patients are on hemodialysis. Because of the differing subtype specificities of the circulating HBsAg and anti-HBs, we conclude that HBsAg and anti-HBs occur concomitantly. The presence of HBeAg, which indicates infectivity, is common in our study group, suggesting that these patients are a reservoir for transmission of hepatitis-B-virus infection. Therefore, the presence of anti-HBs alone does not indicate a noninfectious serum. Concomitant HBsAg and anti-HBs seems to be particularly common in patients with renal disease who are on hemodialysis.
FOUTCH PG, CAREY WD, TABOR E, CIANFLOCCO AJ, NAKAMOTO S, SMALLWOOD LA, et al. Concomitant Hepatitis B Surface Antigen and Antibody in Thirteen Patients. Ann Intern Med. ;99:460–463. doi: 10.7326/0003-4819-99-4-460
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Published: Ann Intern Med. 1983;99(4):460-463.
Infectious Disease, Nephrology, Renal Replacement Therapy.
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