An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen.

TitleAn Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen.
Publication TypeJournal Article
Year of Publication2021
AuthorsCosta V, Zhao Z, Racine-Brzostek SE, Lalazar G, Yang HS
JournalCase Reports Hepatol
Date Published2021

The standard serologic markers used to diagnose hepatitis B infection include hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), total hepatitis B core antibody (anti-HBc), and IgM antibody to hepatitis B core antigen (IgM anti-HBc). Different markers or combinations of markers are used to identify different phases of HBV infection and determine whether a patient has acute or chronic infection or immunity due to prior infection or vaccination or is seronegative and susceptible to future infection. Isolated HBsAg seropositivity is a peculiar serological pattern that requires investigation. Herein, we present a case of an asymptomatic female without a history of liver disease or evident risk factors for hepatitis, who underwent screening for infectious disease prior to resection of basal cell carcinoma involving her eyelid. The patient's laboratory testing showed positivity for HBsAg and the HIV 1/2 screen. To investigate, we performed serial dilutions, utilized heterophilicantibody blocking tubes, and repeated analysis using a different commercial assay (Abbott Architect i2000), all in support of a false-positive result attributed to a heterophilic antibody. Hence, we demonstrate that heterophilic antibody interference can result in isolated HBsAg positivity and recommend considering this form of interference in the differential where there is low clinical suspicion for viral infection.

Alternate JournalCase Reports Hepatol
PubMed ID34336313
PubMed Central IDPMC8313323
Related Faculty: 
He Sarina Yang, M.D., Ph.D. Sabrina Racine-Brzostek, M.D., Ph.D. Zhen Zhao, Ph.D.

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