Concomitant Hepatitis B Surface Antigen and Antibody in Thirteen Patients

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Abstract
Hepatitis B surface antigen (HBsAG) and its antibody (anti-HBs) were found in 13 patients. Nine patients had HBsAg subtype ad; 7 had anti-HBs monotyic subtype anti-y. Nine patients had HBsAg before detectable levels of anti-HBs were present. Of the 6 patients whose serum contained subtypes of HBsAg and anti-HBs, 4 had HBsAg before development of the monotypic antibody. All patients have remained positive for HBsAg and anti-HBs (mean duration, 55.5 wk). Nine patients were postive for HBeAg [hepatitis Be antigen]; 7 had renal disease. Of these 7, 6 are on hemodialysis. Because of the differing subtype specificities of the circulating HBsAg and anti-Hbs, it was concluded that HBsAg and anti-HBs occur concomitantly. The presence of HBeAg, which indicates infectivity, was common in the study group, suggesting that these patients are a reservoir for transmission of hepatitis B virus infection. Therefore, the presence of anti-HBs alone does not indicate a noninfectious serum. Concomitant HBsAg and anti-HBs seem to be particularly common in patients with renal disease who are on hemodialysis.