Epidemiological analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens

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Abstract
To determine the significance of certain serological test results commonly encountered in hepatitis B virus [HBV] testing, serological test data from 9 studies of hepatitis B conducted between 1980-1982 were reviewed. Tests for hepatitis B surface antigen and for antibodies to hepatitis B surface antigen and hepatitis B core antigen (anti-HBs and anti-HBc) were used to measure HBV infection risk in various populations. Two results, low levels of anti-HBs alone and low levels of anti-HBc alone, occurred at constant frequencies (2.72 and 0.4%, respectively), regardless of the prevalence of HBV infection in the population. Positivity for low levels of anti-HBs alone persisted for 1 yr in < 1/2 of those studied; response to HBV vaccine was augmented in only 1/3 of this group. Positivity for low levels of anti-HBc alone did not persist in any of 11 persons studied. Thus, presently available tests for anti-HBs and anti-HBc at low levels are often nonspecific and should be interpreted with caution.