Hepatitis B Vaccination, Screening, and Linkage to Care
Authors: David M. Lowe
Journal: Annals of Internal Medicine (2018)

Letters19 June 2018Hepatitis B Vaccination, Screening, and Linkage to CareDavid M. Lowe, PhDDavid M. Lowe, PhDUniversity College London, London, United Kingdom (D.M.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0100 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Abara and colleagues' (1) guideline on screening and vaccination for hepatitis B virus (HBV) infection is welcome. However, I am concerned that the authors did not mention the potential confounding effect of recent immunoglobulin therapy on serologic tests.As we have described (2), passive transfer of hepatitis B antibodies is extremely common. In our cohort of patients receiving immunoglobulin therapy, at baseline 11.3% tested positive for hepatitis B surface antibody and just 1 patient had equivocal results for hepatitis B core antibody. After a median of 2 years of treatment, all patients tested positive for hepatitis B ...References1. Abara WE, Qaseem A, Schillie S, McMahon BJ, Harris AM; High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention. Hepatitis B vaccination, screening, and linkage to care: best practice advice from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017;167:794-804. [PMID: 29159414]. doi:10.7326/M17-1106 LinkGoogle Scholar2. Ramsay I, Gorton RL, Patel M, Workman S, Symes A, Haque T, et al. Transmission of hepatitis B core antibody and galactomannan enzyme immunoassay positivity via immunoglobulin products: a comprehensive analysis. Clin Infect Dis. 2016;63:57-63. [PMID: 27076567] doi:10.1093/cid/ciw222 CrossrefMedlineGoogle Scholar3. Hartung HP, Mouthon L, Ahmed R, Jordan S, Laupland KB, Jolles S. Clinical applications of intravenous immunoglobulins (IVIg)—beyond immunodeficiencies and neurology. Clin Exp Immunol. 2009;158 Suppl 1:23-33. [PMID: 19883421] doi:10.1111/j.1365-2249.2009.04024.x CrossrefMedlineGoogle Scholar4. Ward C, Lucas M, Piris J, Collier J, Chapel H. Abnormal liver function in common variable immunodeficiency disorders due to nodular regenerative hyperplasia. Clin Exp Immunol. 2008;153:331-7. [PMID: 18647320] doi:10.1111/j.1365-2249.2008.03711.x CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University College London, London, United Kingdom (D.M.L.)Financial Support: Dr. Lowe received support to attend a conference from and participated in an advisory board for Biotest and received travel and accommodation expenses for consultancy work from CSL Behring.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0100. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice From the American College of Physicians and the Centers for Disease Control and Prevention Winston E. Abara , Amir Qaseem , Sarah Schillie , Brian J. McMahon , Aaron M. Harris , and Hepatitis B Vaccination, Screening, and Linkage to Care Winston E. Abara , Amir Qaseem , Sarah Schillie , Brian J. McMahon , and Aaron M. Harris Hepatitis B Vaccination, Screening, and Linkage to Care Jonathan D. Alpern , Thomas M. Leventhal , and Nathan C. Bahr Metrics 19 June 2018Volume 168, Issue 12Page: 901-902KeywordsAntibodiesAntibody therapyAntiviral therapyDisclosureHepatitis BInfectious hepatitisLiver function testsPatientsScreening guidelinesTreatment guidelines ePublished: 19 June 2018 Issue Published: 19 June 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...