Discrepant Hepatitis B Surface Antigen Results in Pregnant Women Screened to Identify Hepatitis B Virus Infection - 23/09/14
, Tanja Y. Walker, MPH 1, †, Nancy Fenlon, MS 2, Chong-Gee Teo, MD, PhD 1, Trudy V. Murphy, MD 1Abstract |
Objective |
To resolve discrepant hepatitis B surface antigen (HBsAg) results for pregnant women screened for hepatitis B virus (HBV) infection.
Study design |
A case was defined as discrepant HBsAg (reactive followed by non-reactive) result during the same pregnancy. The Centers for Disease Control and Prevention examined a convenience sample of cases passively reported by US Perinatal Hepatitis B Prevention Programs. Using a standard form, available results were obtained for hepatitis B tests and vaccination histories. Results were independently reviewed by 3 viral hepatitis experts and a clinical virologist to resolve discrepancies. The initial HBsAg result was classified as probable true positive, probable false positive, or unresolved.
Results |
From April 2009-December 2011, 142 (75.9%) of 187 reported discrepant cases met the case definition. Of the 142 initial reactive HBsAg results, 113 (79.5%) were laboratory-confirmed, and 89 (62.7%) were resolved. Among these 89 cases, the initial test was a probable true positive in 14 (15.7%), and a false positive in 75 (84.3%). Total antibody to hepatitis B core antigen was positive for 11 (78.6%) of the true positive cases and negative for 67 (89.3%) of the false positive cases. True positives included 2 cases of resolving acute HBV infection and one case recently given hepatitis B vaccination.
Conclusions |
In this retrospective analysis of discrepant HBsAg-reactive screening results from pregnant women, the majority were false positives, but true positives occurred. Testing for total hepatitis B core antibody, an indicator of past or current HBV infection, was useful for resolving discrepancies.
Le texte complet de cet article est disponible en PDF.Keyword : Anti-HBc, Anti-HBs, CDC, FDA, HBsAg, HBV, HBV DNA, PHBPP
Plan
| Supported by the Research Participation Program at the Centers for Disease Control and Prevention, administered by the Oak Ridge Institute for Science and Education through an interagency agreement (ORISE Interagency Agreement [12FED1209578]) between the US Department of Energy and the Centers for Disease Control and Prevention. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention. The authors declare no conflicts of interest. |
Vol 165 - N° 4
P. 773-778 - octobre 2014 Retour au numéro
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