Serology of Acute and Chronic Type B Hepatitis

Rogers, Michael J.; Davis, Gary L.

doi:10.1159/000171225

Cited by 1 publication

(2 citation statements)

References 20 publications

(56 reference statements)

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“…Similarly, the prescription of HBsAg alone should be considered unhelpful. Although HBsAg is the first antigen dosable in the blood after HBV infection [15], it may be detected in the patient's serum over several weeks after the infection itself. On the other hand, HBsAg is not infectious per se and is not associated with viral particles.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the appropriateness of hepatitis B serology testing prescribed by general practitioners in a selected area of southern Italy

Miragliotta

Santacroce

Vinci

2007

Evaluation Clinical Practice

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Aside from the increasing number of doctors' prescriptions of clinical laboratory tests, it appears noteworthy that such prescriptions are very often inappropriate [1]. In this study, we collected and evaluated doctors' prescription forms sent for the screening of the viral hepatitis B in the health district of Fasano (Brindisi, Apulia, southern Italy). We selected such an area because its population (about 37 000) is representative of Apulian citizens and may be easily monitored. Materials and methodsA total of 310 laboratory requisition forms released because of hepatitis B virus (HBV) suspicion over the period JanuaryDecember 2005 were considered. For any prescription, (i) the formal correctness (i.e. patient's name, age, address, health code, doctor's stamp, code and signature); (ii) the diagnostic hypothesis; (iii) the number and type of tests; and (iv) the use of the correct test names [e.g. hepatitis B surface antigen (HBsAg)] were carefully checked.The serological diagnostic approach to hepatitis consists of tests that allow, on the basis of the knowledge of the viral life cycle, the determination of both the causative virus and the infection status [2]. With regard to type B viral hepatitis, the dosages of alanine aminotransferase (ALT), urinary urobilinogen, as well as of immunoglobulin M (IgM) antibody to hepatitis B core antigen (antiHBc) or HBsAg, should be considered the markers of acute infection [3][4][5][6][7][8]. Therefore, those tests should be regarded as essential for the diagnosis of type B hepatitis, at least from a laboratory point of view. In our study, all prescriptions for any of the virological markers of HBV (i.e. HBsAg, antibody to hepatitis B surface antigen (anti-HBs), anti-HBc IgM, anti-HBc total, hepatitis B e antigen (HBeAg) and antibody to hepatitis B e antigen (anti-HBe)) were included in the analysis. Requests that did not prove useful for the laboratory diagnosis according to the above criteria were tagged as 'inappropriate'.

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Section: Discussionmentioning

confidence: 99%

“…As the isolated positivity of anti‐HBc total is compatible with both non‐acute infection (i.e. prior infection) and the so‐called window period of the infection, the dosage of anti‐HBc IgM and anti‐HBe is recommended in order to avoid a false result [15,18–20].…”

Section: Discussionmentioning

confidence: 99%