Of 1,801 Chinese subjects, age 1 to 90 years, screened for hepatitis B surface antigen and antibody (HBsAg, anti‐HBs) and antibody to hepatitis B core antigen (anti‐HBc), 214 (11.9%) had an isolated, positive anti‐HBc result; anti‐HBc was reproducibly present in the initial sera in only 66% and persisted after an interval of 2 weeks to 3 months in only 73%. There was a strong correlation between the rates of reproducibility and persistence of isolated anti‐HBc and the initial anti‐HBc titers. Thirty‐two subjects with persistent, isolated anti‐HBc received four doses of hepatitis B vaccine (5 μg, HEVAC B) at 0, 1, 2 and 12 months: 56% developed a primary anti‐HBs response in response to hepatitis B vaccine, 16% developed an anamnestic or secondary anti‐HBs response, and 28% were undetectable for anti‐HBs even after four doses of vaccine. The low rates of reproducibility and persistence of anti‐HBc together with the high rate of primary anti‐HBs response to hepatitis B vaccine in subjects with isolated anti‐HBc raise doubts as to the reliability of anti‐HBc (Corzyme, Abbott Laboratories, North Chicago, Ill.) as a single screening test for hepatitis B infection prior to vaccination and suggests that subjects with isolated anti‐HBc, in particular those with low anti‐HBc titers, be included in vaccination programs.
Hepatology – Wiley
Published: Jul 1, 1988
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