An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), total hepatitis B core antibody (anti-HBc), and IgM antibody to hepatitis B core antigen (IgM anti-HBc). Different markers or combinations of ma...
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Published in | Case reports in hepatology Vol. 2021; pp. 1 - 3 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Hindawi
19.07.2021
Hindawi Limited |
Subjects | |
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Abstract | The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), total hepatitis B core antibody (anti-HBc), and IgM antibody to hepatitis B core antigen (IgM anti-HBc). Different markers or combinations of markers are used to identify different phases of HBV infection and determine whether a patient has acute or chronic infection or immunity due to prior infection or vaccination or is seronegative and susceptible to future infection. Isolated HBsAg seropositivity is a peculiar serological pattern that requires investigation. Herein, we present a case of an asymptomatic female without a history of liver disease or evident risk factors for hepatitis, who underwent screening for infectious disease prior to resection of basal cell carcinoma involving her eyelid. The patient’s laboratory testing showed positivity for HBsAg and the HIV 1/2 screen. To investigate, we performed serial dilutions, utilized heterophilicantibody blocking tubes, and repeated analysis using a different commercial assay (Abbott Architect i2000), all in support of a false-positive result attributed to a heterophilic antibody. Hence, we demonstrate that heterophilic antibody interference can result in isolated HBsAg positivity and recommend considering this form of interference in the differential where there is low clinical suspicion for viral infection. |
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AbstractList | The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), total hepatitis B core antibody (anti-HBc), and IgM antibody to hepatitis B core antigen (IgM anti-HBc). Different markers or combinations of markers are used to identify different phases of HBV infection and determine whether a patient has acute or chronic infection or immunity due to prior infection or vaccination or is seronegative and susceptible to future infection. Isolated HBsAg seropositivity is a peculiar serological pattern that requires investigation. Herein, we present a case of an asymptomatic female without a history of liver disease or evident risk factors for hepatitis, who underwent screening for infectious disease prior to resection of basal cell carcinoma involving her eyelid. The patient’s laboratory testing showed positivity for HBsAg and the HIV 1/2 screen. To investigate, we performed serial dilutions, utilized heterophilicantibody blocking tubes, and repeated analysis using a different commercial assay (Abbott Architect i2000), all in support of a false-positive result attributed to a heterophilic antibody. Hence, we demonstrate that heterophilic antibody interference can result in isolated HBsAg positivity and recommend considering this form of interference in the differential where there is low clinical suspicion for viral infection. |
Author | Zhao, Zhen Lalazar, Gadi Yang, He S. Racine-Brzostek, Sabrina E. Costa, Victoria |
AuthorAffiliation | 1 Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA 2 Department of Gastroenterology and Hepatology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA |
AuthorAffiliation_xml | – name: 2 Department of Gastroenterology and Hepatology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA – name: 1 Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA |
Author_xml | – sequence: 1 givenname: Victoria orcidid: 0000-0001-7762-0513 surname: Costa fullname: Costa, Victoria organization: Department of Pathology and Laboratory MedicineNew York Presbyterian HospitalWeill Cornell MedicineNew YorkNYUSAnyp.org – sequence: 2 givenname: Zhen orcidid: 0000-0002-9742-5982 surname: Zhao fullname: Zhao, Zhen organization: Department of Pathology and Laboratory MedicineNew York Presbyterian HospitalWeill Cornell MedicineNew YorkNYUSAnyp.org – sequence: 3 givenname: Sabrina E. orcidid: 0000-0002-6296-6682 surname: Racine-Brzostek fullname: Racine-Brzostek, Sabrina E. organization: Department of Pathology and Laboratory MedicineNew York Presbyterian HospitalWeill Cornell MedicineNew YorkNYUSAnyp.org – sequence: 4 givenname: Gadi orcidid: 0000-0001-7392-3082 surname: Lalazar fullname: Lalazar, Gadi organization: Department of Gastroenterology and HepatologyNew York Presbyterian HospitalWeill Cornell MedicineNew YorkNYUSAnyp.org – sequence: 5 givenname: He S. orcidid: 0000-0001-5827-992X surname: Yang fullname: Yang, He S. organization: Department of Pathology and Laboratory MedicineNew York Presbyterian HospitalWeill Cornell MedicineNew YorkNYUSAnyp.org |
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Cites_doi | 10.1002/hep.28503 10.1093/rheumatology/kev088.001 10.1111/vox.12675 10.1373/clinchem.2018.294157 10.1007/s00430-010-0160-3 10.1111/j.1440-1746.1993.tb01672.x 10.1016/j.cca.2008.09.030 10.1373/clinchem.2004.040501 |
ContentType | Journal Article |
Copyright | Copyright © 2021 Victoria Costa et al. Copyright © 2021 Victoria Costa et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0 Copyright © 2021 Victoria Costa et al. 2021 |
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References | 11 1 2 Centers for Disease Control and Prevention (9) 2018 3 4 5 6 J. Tate (8) 2004; 25 7 N. Stuempfig (10) 2019 |
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SubjectTerms | Antigens Architects Bacterial infections Cancer Case Report Case reports Hepatitis B HIV Human immunodeficiency virus Immunoassay Infections Laboratories Liver diseases Monoclonal antibodies Reagents Risk factors Serology Viruses |
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Title | An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen |
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