Antibody against the translation product of the pre-S2 region of hepatitis B virus and the resolution of infection after accidental needlestick exposure.

During a 5-yr period before the introduction of post-exposure immunoprophylaxis of hepatitis B virus (HBV), 363 medical personnel contracted infection after exposure to a contaminated needlestick. Among them, five (1.4%) developed a persistent carrier state, and they were followed for antibodies against translation product of the pre-S2 region (anti-pre-S2) by the enzyme immunoassay with native viral polypeptides. The consecutive seven cases in whom infection was terminated served as controls. In the acute phase, the levels of IgM and IgG anti-pre-S2 were significantly higher in the seven in whom infection resolved than in the five in whom infection persisted (mean sample:normal ratio, 11.1 +/- 4.4 vs 2.0 +/- 1.3 and 8.7 +/- 7.0 vs 3.0 +/- 1.1, respectively, p less than 0.05). In convalescence, 6 months after the normalization of serum transaminase, IgG anti-pre-S2 was detected in a high titer in the staff members with resolved infection (27.4 +/- 38.5), but was not detectable in those with persistent infection. On the basis of these observations, the intensity of humoral antibody response against the pre-S2 region product is closely correlated with the resolution of infection after exposure to HBV, and anti-pre-S2 persists in the circulation much longer than previously reported.