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Concomitant Hepatitis B Surface Antigen and Antibody in Thirteen Patients

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.; and ROBERT J. GERETY, M.D., Ph.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to William D. Carey, M.D.; Department of Gastroenterology, Cleveland Clinic Foundation, 9500 Euclid Avenue; Cleveland, OH 44106.


Cleveland, Ohio; and Bethesda, Maryland


© 1983 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1983;99(4):460-463. doi:10.7326/0003-4819-99-4-460
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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.

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