Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 52: 1457-1459, 2006; 10.1373/clinchem.2006.072504
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dufour, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dufour, D. R.
Related Collections
Right arrow Infectious Disease
Right arrow Proteomics and Protein Markers
(Clinical Chemistry. 2006;52:1457-1459.)
© 2006 American Association for Clinical Chemistry, Inc.

Editorial

Hepatitis B Surface Antigen (HBsAg) Assays—Are They Good Enough for Their Current Uses?

D. Robert Dufour

Veterans Affairs Medical Center, Washington, DC, and, George Washington University Medical Center, Washington, DC, E-mail d.robert.dufour@med.va.gov

The first 300 words of the full text of this article appear below.

Hepatitis B virus (HBV) is the most common significant chronic viral infection world-wide. Approximately 350–400 million people have active HBV infections, and as many as one third of the world’s population has evidence of exposure to HBV. Spread of the virus occurs primarily through contact with infected serum, sexual contact with infected individuals, and vertical transmission from mother to infant. Since shortly after its discovery as the "Australia antigen" (1), hepatitis B surface antigen (HBsAg) has been the principal target for laboratory testing to identify active infection by HBV. Accumulating evidence, including the article by Chen and Kaplan (2) in this issue of Clinical Chemistry, calls into question the degree to which HBsAg assays can be used as the "gold standard" for detecting HBV infection. The increasing availability of automated assays for viral markers on instruments traditionally found in immunochemistry laboratories makes it imperative for those working in such laboratories to be familiar with issues in HBsAg testing.


natural history of hbv infection

Exposure to HBV has a variable outcome that is largely determined by the age and immune status of an infected individual. In healthy adolescents and adults, the most common population exposed to HBV in northern Europe and most of North America, exposure to HBV typically leads to acute hepatitis, followed by loss of detectable HBsAg and loss of circulating HBV DNA (as measured by most assays). Chronic infection, identified by persistence of HBsAg, may follow infections in infants, persons with immunosupression, and a small number of otherwise healthy individuals. Such chronic infection may be associated with active viral replication (detected by circulating HBV DNA), or with "nonreplicating" infection, in which HBsAg continues to be produced but HBV DNA is undetectable (by most assays) in the circulation. Replicating forms of infection can convert to nonreplicating forms, either spontaneously . . . [Full Text of this Article]


falsely positive hbsag results and neutralization assays


false-negative hbsag results


occult hbv infection


hbsag "escape" mutants


what should laboratories and manufacturers do to improve hbv detection?






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Association for Clinical Chemistry.