I'm a Orthopaedic Surgeon. I have complete vaccination 25 years ago and my blood panel was always HepBsAg negative and anti HBS Antibody was always more 500mIU/mL. Last test was in April 2012.....HepBsAG not detected and HBS antibody was 500. Last week during a routine check...my panel came back as HepBsAg detected with HBS antibody at 513 mIU/mL......am confused and extremely worried now....waiting for confirmation. Liver panel were normal.Kindly advice...Tq

I think confirmatory testing with repeat sAg and testing for HBV DNA is important. It is surprising for someone to acquire hepatitis B after being appropriately vaccinated and mounting a sAb response. I hope this is a lab error or some other type of error with reporting the results.

If your sAg comes back reactive and DNA detectable, this would be unusual. Refer to "Society for Healthcare Epidemiology of America (SHEA)SHEA Guideline for Management of Healthcare Workers Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus," Infection Control and Hospital Epidemiology March 2010, vol. 31, no. 3, written by Henderson and colleagues. These may be found at may be found at http://www.shea-online.org/Assets/files/guidelines/BBPathogen_GL.pdf.

All best. LT