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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