Schifman R B, Rivers S L, Sampliner R E, Krammes J E
Department of Pathology, Tucson Veterans Affairs Medical Center, AZ.
Arch Intern Med. 1993 Oct 11;153(19):2261-6.
About 25% of blood donors who test positive for antibody to hepatitis B core antigen (anti-HBc) have no other positive hepatitis B serologic results. Because of the potential importance and diagnostic uncertainty of this test result, we studied its significance by assessing the serologic response to hepatitis B vaccine in donors with an isolated anti-HBc pattern.
Specimens from 300 blood donors that were positive for anti-HBc by enzyme immunoassay were tested for anti-HBc by radioimmunoassay and for antibody to hepatitis B surface antigen (anti-HBs). A subgroup of 37 were further studied after administration of hepatitis B vaccine and compared with 34 similarly vaccinated age- and sex-matched seronegative controls. Measurements of anti-HBs were made at vaccination and 1, 2, 4, 8, 25, and 30 weeks after initial vaccination.
Among 300 donors who tested positive for anti-HBc by enzyme immunoassay, the radioimmunoassay for anti-HBc was negative in 76 (25.3%) and the test for anti-HBs was negative in 104 (34.7%). Significant differences were observed for radioimmunoassay anti-HBc and anti-HBs titers, alanine aminotransferase, and male-female ratios between four distinct serogroups (A through D) defined by the combination (positive/negative) of radioimmunoassay anti-HBc and anti-HBs results. No significant differences between the study and control groups were observed in the magnitude of anti-HBs responses at any of the six postvaccine testing periods.
Isolated anti-HBc in US blood donors is usually a false-positive result, regardless of the titer.
约25%乙肝核心抗原抗体（抗-HBc）检测呈阳性的献血者没有其他乙肝血清学阳性结果。由于该检测结果的潜在重要性及诊断不确定性，我们通过评估孤立抗-HBc模式献血者对乙肝疫苗的血清学反应来研究其意义。
对300名酶免疫法检测抗-HBc呈阳性的献血者标本进行放射免疫法检测抗-HBc及乙肝表面抗原抗体（抗-HBs）。37名亚组献血者接种乙肝疫苗后进一步研究，并与34名年龄和性别匹配的接种疫苗血清阴性对照者比较。在接种疫苗时及初次接种后1、2、4、8、25和30周测量抗-HBs。
在300名酶免疫法检测抗-HBc呈阳性的献血者中，76名（25.3%）放射免疫法检测抗-HBc为阴性，104名（34.7%）抗-HBs检测为阴性。根据放射免疫法抗-HBc和抗-HBs结果的组合（阳性/阴性）定义的四个不同血清学组（A至D）之间，放射免疫法抗-HBc和抗-HBs滴度、丙氨酸转氨酶及男女比例存在显著差异。在六个疫苗接种后检测期的任何一个时间点，研究组和对照组之间抗-HBs反应强度均未观察到显著差异。
美国献血者中孤立的抗-HBc通常是假阳性结果，无论滴度如何。
