Unnecessary Prophylaxis for Phantom Hepatitis

Excerpt

To the editor: Many patients receive hepatitis A post-exposure immunoglobulin prophylaxis unnecessarily because of misinterpretation of laboratory tests. We report three examples that illustrate this increasingly common phenomenon.

A 92-year-old female resident of a skilled nursing facility was admitted for evaluation of malaise and anorexia accompanied by liver function test abnormalities. The patient's physician called the nursing facility to recommend immunoglobulin prophylaxis for employee contacts based on a diagnosis of hepatitis A. This diagnosis was made on the basis of a negative test for hepatitis B surface antigen and a hepatitis A report stating: "specimen is positive for IgG antibodies and negative for IgM antibodies