Failure of preexisting antibody against hepatitis B surface antigen to prevent subsequent hepatitis B infection

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Abstract
A patient who developed acute hepatitis B virus (HBV) infection despite the presence of preexisting antibody to the surface antigen of HBV (anti-HBs) was studied. Anti-HBs was reported to consist primarily of antibody against the common a determinant of HBV. Antibody directed against this major determinant appears to confer protection against HBV, regardless of the subtype. The patient was shown to have had preexisting anti-HBs of anti-d but not anti-a specificity. She subsequently developed non-A, non-B viral hepatitis followed by an episode of acute hepatitis B after exposure to HBV of the ayw subtype.