Werner B G, Dienstag J L, Kuter B J, Polk B F, Snydman D R, Craven D E, Crumpacker C S, Platt R, Grady G F
Ann Intern Med. 1985 Aug;103(2):201-5. doi: 10.7326/0003-4819-103-2-201.
To determine the need for immunization of health workers with antibody to hepatitis B surface antigen (anti-HBs) as their only serologic marker of previous hepatitis B exposure, we studied the level, persistence, and immunologic specificity of isolated anti-HBs in 46 persons identified during screening for hepatitis B vaccine. We rescreened these persons 1 year later, administered a single dose of hepatitis B vaccine, and determined the anti-HBs level at 1, 2, and 8 weeks after vaccination. Isolated anti-HBs levels were low and antibody did not persist; 22 subjects tested had lost detectable anti-HBs within 19 months even though immunologic specificity was shown in vitro in 34. Anamnestic responses suggesting previous exposure and immunity were seen in only 10 subjects; 5 of these subjects had moderate-level, persistent anti-HBs. Although some persons with naturally acquired, isolated anti-HBs may be protected from hepatitis B, the immunologic specificity and protective value of anti-HBs, especially when levels are low, remain questionable.
为了确定仅以乙肝表面抗原抗体（抗-HBs）作为既往乙肝暴露唯一血清学标志物的医护人员是否需要进行免疫接种，我们研究了在乙肝疫苗筛查过程中确定的46名人员中分离出的抗-HBs的水平、持久性和免疫特异性。1年后我们对这些人员再次进行筛查，接种一剂乙肝疫苗，并在接种后1周、2周和8周测定抗-HBs水平。分离出的抗-HBs水平较低且抗体不能持久存在；22名检测对象在19个月内抗-HBs检测不到，尽管在34名对象中体外显示有免疫特异性。仅在10名对象中观察到提示既往暴露和免疫的回忆反应；其中5名对象有中等水平、持久的抗-HBs。尽管一些自然获得分离抗-HBs的人可能对乙肝有免疫力，但抗-HBs的免疫特异性和保护价值，尤其是水平较低时，仍存在疑问。
