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Isolated Antibody to Hepatitis B Surface Antigen and Response to Hepatitis B Vaccination

BARBARA G. WERNER, Ph.D.; JULES L. DIENSTAG, M.D.; BARBARA J. KUTER, M.P.H.; B. FRANK POLK, M.D.; DAVID R. SNYDMAN, M.D.; DONALD E. CRAVEN, M.D.; CLYDE S. CRUMPACKER, M.D.; RICHARD PLATT, M.D.; and GEORGE F. GRADY, M.D.
[+] Article and Author Information

Grant support: In part by a grant from the Department of Virus and Cell Biology Research, Merck Sharp & Dohme, West Point, Pennsylvania.

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


Boston, Massachusetts; and West Point, Pennsylvania


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;103(2):201-205. doi:10.7326/0003-4819-103-2-201
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To determine the need for immunization of health workers with antibody to hepatitis B surface antigen (anti-HBs) as their only serologic marker of previous hepatitis B exposure, we studied the level, persistence, and immunologic specificity of isolated anti-HBs in 46 persons identified during screening for hepatitis B vaccine. We rescreened these persons 1 year later, administered a single dose of hepatitis B vaccine, and determined the anti-HBs level at 1, 2, and 8 weeks after vaccination. Isolated anti-HBs levels were low and antibody did not persist; 22 subjects tested had lost detectable anti-HBs within 19 months even though immunologic specificity was shown in vitro in 34. Anamnestic responses suggesting previous exposure and immunity were seen in only 10 subjects; 5 of these subjects had moderate-level, persistent anti-HBs. Although some persons with naturally acquired, isolated anti-HBs may be protected from hepatitis B, the immunologic specificity and protective value of anti-HBs, especially when levels are low, remain questionable.

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