May 27, 2006
I have a patient with HBsag negative, Core total positive, and HBsab negative. Why would the HBsab be negative if the core total is positive?
| Response from Dr. McGovern
This is referred to as "isolated core antibody positivity". I will refer to it as ICAP.
ICAP can be seen in acute hepatitis B (need then to check IgM fraction of the core) ICAP can be a false positive ICAP can be seen with past infection in patients who have lost their protective surface antibodies over time.
We have a paper on this topic. I hope it is helpful to you. Gandhi RT, Wurcel A, Lee H, McGovern B, et al. Isolated antibody to hepatitis B core antigen in human immunodeficiency virus-infected individuals. Clinical Infectious Diseases 2003; 36:1602-5.
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