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Accidental Hepatitis-B-Surface-Antigen-Positive Inoculations: Use of e Antigen to Estimate Infectivity

BARBARA G. WERNER, Ph.D.; and GEORGE F. GRADY, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Barbara G. Werner, Ph.D.; State Laboratory Institute, 305 South Street; Jamaica Plain, MA 02130.


Boston, Massachusetts


©1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;97(3):367-369. doi:10.7326/0003-4819-97-3-367
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We assessed the ability of radioimmunoassay for hepatitis B e antigen (HBeAg) to predict infectivity in exposed medical personnel by analyzing 390 samples of sera positive for hepatitis B surface antigen (HBsAg) that were implicated in accidental inoculations of known outcome. The radioimmunoassay detected HBeAg or its antibody (anti-HBe) in 91% of the donor sera. The incidence of hepatitis B was 19% (44 of 234) in recipients of HBeAg-positive sera but was only 2.5% (three of 121) in recipients of sera positive for anti-HBe, and nil (none of 35) in recipients of sera negative for HBeAg and anti-HBe. The known relation of HBeAg and infectivity was quantified by radioimmunoassay as a risk ratio of 10:1 (HBeAg-positive to HBeAg-negative) for this type of exposure. The sensitivity of the radioimmunoassay also showed that a large proportion (55%) of donor sera not producing hepatitis were positive for HBeAg; therefore, even the most flagrant needlestick exposures to HBsAg-positive sera often must involve subthreshold amounts of infective material.

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