THE SIGNIFICANCE OF ISOLATED HEPATITIS B SURFACE ANTIGEN: A CASE REPORT AND REVIEW OF LITERATURE

Majd Alsayb*, MD, Farah Al Gamdi and May A. Alsayb

ABSTRACT

Background: One of the common cause of viral hepatitis is Hepatitis B virus. Acute infection is characterized by the appearance of HbsAg, HBcIgM and detectable HBV DNA. Isolated HbsAg positivity is unusual serological marker with no clear interpretation neither its significance. Case presentation: A 38year old Saudi male patient who had a screening test that showed an isolated HbsAg positivity with undetectable HBV DNA repeatedly. We considered his isolated HbsAg as a false positive test. He received 3 doses of recombinant hepatitis B vaccines. His follow up serology showed negative HbsAg, HbsAB was 51.4 mIU/mL and HbcAB remained negative. Conclusion: Weakly isolated HBsAg positivity often do not reflect actual HBV infection. Different possible mechanisms could lead to this unusual serological profile and further investigations and confirmations should be considered in the interpretation guideline for hepatitis B infection.

Keywords: Hepatitis B surface antigen (HBsAg), Hepatitis B surface Antibodies (HBsAB), Hepatitis B core Antibodies (HBcAB), hepatitis B core antigen (HBcAg), hepatitis B envelope antigen (HBeAg), hepatitis B envelope antibodies (HBeAb), chemiluminescent micropartic