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HBV vacinated now HBV+
Jun 28, 2005

Hi Dr Mcgovern

My wife is from the Philippines, screened at Am Embassy, Jun2000, for ALL Hep, etc. Fine. Started working in a hospital(housekeeping). Screened by that Hospital(Sep2001), all fine. Became CNA, screened again(Mar2004), and got all 3 series of HBV shots. Fine!

Went into Dr., routine OB/GYN, took blood, Dr sez HBs AG Pos, HBS AB Neg, HBc AB Pos, HBV E AG pos,HBV E AB non react.

Three tests, with 3 screens, and full HBV vacs. Now HBV +??? Impossible? Recs and thoughts highly appreciated

Response from Dr. McGovern

I have two thoughts on this subject:

My first thought is frankly lab error (ie, you got someone else's blood test result). I agree that after all the screening and immunization, the chance of developing chronic hepatitis B now seeems low.

My second thought is that she is in the health care profession so perhaps there could have been an exposure, but I would think that she would have some memory of one.

Finally, I would check the records to see if her antibody titers (surface antibody) were checked after she got her third HBV immunization to see if she developed protective antibodies. This kind of testing is not routinely done so I am not sure the information will be available. Sometimes, patients do not respond to vaccine.

I would ask for repeat testing with hepatitis B DNA testing to be certain that she is truly positive. The good news is that there are multiple treatments available now. She should get her testing in Employee Health for documentation.

Dr. McGovern



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