HEPATITIS-B VACCINATION ALONE IS NOT ADEQUATE FOR THE CATEGORIZING OFADULT SUBJECTS WITH ISOLATED ANTI-HBC

To evaluate the meaning of isolated antibody to hepatitis B core antig en (anti-HBc), 88 Chinese subjects with isolated anti-HBc received res creening of hepatitis B virus (HBV) markers. Eighty (90.9%) of them we re still positive for this antibody and 29 were also found to be posit ive for antibody to hepatitis B surface antigen (anti-HBs). The remain ing 51 subjects (58.0%) were positive for anti-HBc alone; 50 of them r eceived a four-dose schedule of hepatitis B (HB) vaccine. After the in itial dose, only one vaccinee disclosed an amnestic anti-HBs response, that is, anti-HBs titre > 1000 miu/mL. Forty-five vaccinees completed the vaccination schedule and 44(97.8%) had anti-HBs response. The ant i-HBs responses in 25 of these vaccinees were compared with 25 age- an d sex-matched normal susceptible vaccinees. The anti-HBs response rate s in both groups were the same (96 vs 96%). However, the geometric mea n titre was significantly lower in the vaccinees with isolated anti-HB c (512 mIU/mL vs 4688 mIU/mL, P < 0.001). Prevaccinated sera were avai lable in 49 vaccinees with isolated anti-HBc for detection of antibody to hepatitis B e antigen (anti-HBe) and HBV DNA; 37 (75.5%) of them h ad one or two of these markers. As we regarded the rescreening of HBV markers, response to hepatitis B vaccination and presence or absence o f anti-HBe and/or HBV DNA together for categorizing the 88 subjects wi th isolated anti-HBc, at least three-quarters of them had past infecti on of HBV. The subjects with false positive anti-HBc test were a minor group concluded that the presence or absence of amnestic anti-HBs res ponse to HE vaccination is not a reliable indicator for categorizing s ubjects with isolated anti-HBc. Rescreening of HBV markers, with addit ion of anti-HBe and HBV DNA, may be helpful in determining the necessi ty of HE vaccination.