Isolated antibody to hepatitis B surface antigen and response to hepatitis B vaccination

• Published in: Annals of internal medicine Vol. 103; no. 2; p. 201
• Main Authors: Werner, B G, Dienstag, J L, Kuter, B J, Polk, B F, Snydman, D R, Craven, D E, Crumpacker, C S, Platt, R, Grady, G F
• Format: Journal Article
• Language: English
• Published: United States 01.08.1985
• Subjects: Antibody Specificity; Hepatitis B Antibodies - analysis; Hepatitis B Core Antigens - immunology; Hepatitis B Surface Antigens - immunology; Hepatitis B Vaccines; Humans; Immunization, Secondary; Immunologic Memory; Time Factors; Viral Hepatitis Vaccines - immunology
• ISSN: 0003-4819
• DOI: 10.7326/0003-4819-103-2-201

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.