Significance of antibody to hepatitis B core antigen in a hemodialysis unit.

Serum hepatitis B surface antigen (HB(s)Ag), antibody to HB(s)Ag (anti-HB(s)) and antibody to hepatitis B core antigen (anti-HB(c)) were determined serially in patients and staff in a hemodialysis unit. A low prevalence of HB(s)Ag (2.8 percent) was found. However, in patients without HB(s)Ag, anti-HB(c) alone was present in 9.2 percent, and coexistent anti-HB(s) and anti-HB(c) in 19.2 percent. In persons with anti-HB(c) only, the levels of anti-HB(c) correlate positively with abnormal results on liver function studies (LFS). In all subjects with abnormal LFS findings, anti-HB(c) levels were greater than 6.04 radioimmunoassay (RIA) units. In subjects with both anti-HB(s) and anti-HB(c), all five subjects with higher anti-HB(c) relative levels had abnormal LFS results and all subjects with normal LFS results had higher anti-HB(s) relative levels. Along with other recent reports in the literature, these findings suggest a hepatitis B prevalence in this hemodialysis unit far in excess of that anticipated on the basis of HB(s)Ag prevalence.