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

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 ma...

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Main Authors: Victoria Costa, Zhen Zhao, Sabrina E. Racine-Brzostek, Gadi Lalazar, He S. Yang
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Hepatology
Online Access:http://dx.doi.org/10.1155/2021/9928098
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author Victoria Costa
Zhen Zhao
Sabrina E. Racine-Brzostek
Gadi Lalazar
He S. Yang
author_facet Victoria Costa
Zhen Zhao
Sabrina E. Racine-Brzostek
Gadi Lalazar
He S. Yang
author_sort Victoria Costa
collection DOAJ
description 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.
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spelling doaj-art-7313ca49a00a447b97cc662a94aaeeae2025-08-20T03:33:50ZengWileyCase Reports in Hepatology2090-65872090-65952021-01-01202110.1155/2021/99280989928098An Interesting Case of Isolated False-Reactive Hepatitis B Surface AntigenVictoria Costa0Zhen Zhao1Sabrina E. Racine-Brzostek2Gadi Lalazar3He S. Yang4Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USADepartment of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USADepartment of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USADepartment of Gastroenterology and Hepatology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USADepartment of Pathology and Laboratory Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USAThe 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.http://dx.doi.org/10.1155/2021/9928098
spellingShingle Victoria Costa
Zhen Zhao
Sabrina E. Racine-Brzostek
Gadi Lalazar
He S. Yang
An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
Case Reports in Hepatology
title An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
title_full An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
title_fullStr An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
title_full_unstemmed An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
title_short An Interesting Case of Isolated False-Reactive Hepatitis B Surface Antigen
title_sort interesting case of isolated false reactive hepatitis b surface antigen
url http://dx.doi.org/10.1155/2021/9928098
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