Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology
Original article

Analysis of Clinical Features and Hepatitis B Virus DNA Level in the Concomitant Cases of Hepatitis B Surface Antigen and Antibody

Byung Ryul Jeon, Rojin Park, Jeong Won Shin, Tae Youn Choi, Hee Bong Shin1, You Kyung Lee1, Young Jin Choi2, Hwi Jun Kim2, and Jee Young Ahn3

Department of Laboratory Medicine, College of Medicine, Soonchunhyang University, Seoul, Bucheon1, Cheonan2and Gumi3, Korea

Corresponding to Tae Youn Choi, E-mail: choity@hosp.sch.ac.kr

Ann Clin Microbiol 2004;7(2):105-110.
Copyright © Korean Society of Clinical Microbiology.

Abstract

Background : After an infection with HBV, HBsAg is the first virologic marker detectable in the serum. If anti-HBs against ‘a’ determinant of HBsAg appears, HBsAg will disappear and the patients will recover from the HBV infection in most cases. However, we encounter not infrequently concomitant cases of HBsAg and anti-HBs. In this study we evaluated HBV DNA levels in concomitant cases to aid in the interpretation of these serologic results.

Methods : This study included 36 cases with positivity for both HBsAg and anti-HBs in an electrochemiluminescent immunoassay as well as a radioimmunoassay. They were tested for HBeAg, anti-HBe, and HBV DNA levels.

Results : Chronic viral hepatitis was the most frequent diagnosis (15/36 : 41.7%) and AST and ALT levels were normal in 17 (47.2%) and 20 (55.6%) cases, respectively, among total 36 concomitant cases. HBeAg was positive in 24 and anti-HBe in 17 cases. HBV DNA was positive in 33 cases (91.7%). including all 24 HBeAg positive cases and 9 (75%) of 12 HBeAg negative cases; 6 (50%) of 12 HBeAg negative cases had HBV DNA levels higher than 105copy/mL.

Conclusions : This study showed that viral replication still exists in most cases of concomitant HBsAg and anti-HBs, and even in some HBeAg negative cases. So in the concomitant cases, HBV DNA quantitation may aid in the interpretation of clinical significance of these cases. (Korean J Clin Microbiol 2004;7(2):105-110)

Keywords

Hepatitis B virus, DNA, HBsAg, anti-HBs, HBeAg