Screening of Health Care Workers Before Hepatitis B Vaccination: More Questions than Answers

Excerpt

Immunoassays for hepatitis B viral markers are extremely sensitive diagnostic tools. However, in the past few years several studies have raised concerns about the reliability of an isolated finding of antibody to hepatitis B surface antigen (anti-HBs) or core antigen (anti-HBc) as an indicator of past infection with hepatitis B virus (1-8). Particular emphasis has been placed on the questionable biologic significance of isolated anti-HBs. In brief, these studies have shown the following: first, isolated, low-level anti-HBs occurs in several nonprimate animal species that lack susceptibility to hepatitis B virus infection (1, 2); second, health care workers and chimpanzees with