HAROLD A. KESSLER, M.D.; ALAN A. HARRIS, M.D.; JOHN A. PAYNE, M.D.; EDSEL HUDSON, M.D.; BENJAMIN POTKIN, M.D.; STUART LEVIN, M.D.
The epidemiologic and serologic differences between hospital employees with antibodies to hepatitis B surface antigen (anti-HBs) alone or in combination with antibodies to hepatitis B core antigen (anti-HBc) were evaluated. Of 105 employees with anti-HBs, 38 (36%) did not have anti-HBc. Sera from employees with anti-HBs alone had significantly lower mean sample ratio units of anti-HBs than sera with both antibodies (15.9 ± 43.2 as compared to 110.3 ± 73.9, p < 0.0005) and more commonly had less than 10 sample ratio units of anti-HBs (32 [84%] of 38 as compared to 9 [13%] of 67, p = 0.0001). The anti-HBs in sera with anti-HBs alone was predominantly IgM as shown by inactivation with 2-mercaptoethanol and the presence of anti-HBs activity in serum IgM fractions. Failure of protection from hepatitis B virus infection in persons with anti-HBs alone and the presence of nonprotective IgM anti-HBs in chimpanzees has been reported. Our data suggest the use of anti-HBs as a single serologic screening test for hepatitis B virus immunization programs may not be reliable in identifying employees with protective antibodies.
KESSLER HA, HARRIS AA, PAYNE JA, et al. Antibodies to Hepatitis B Surface Antigen as the Sole Hepatitis B Marker in Hospital Personnel. Ann Intern Med. 1985;103:21–26. doi: https://doi.org/10.7326/0003-4819-103-1-21
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Published: Ann Intern Med. 1985;103(1):21-26.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease, Prevention/Screening.
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