Pathway for vaccination of an individual at risk of Hepatitis B with no previous vaccination history

Warning

sAb: surface Antibody    sAg: surface Antigen  cAb: core Antibody    eAb: e Antibody       

*Possible causes of Isolated positive HBV cAb
1. False positive – this is more likely in someone with no risk factors for HBV
2. Early resolving infection when sAg has gone and sAb is about to develop
3. Resolved Hepatitis B with waning sAb titres (often eAb is positive too)
4. Occult HBV infection – this occurs rarely. There is low level virus but no detectable sAg.

Hepatitis B infection may reactivate especially in those who are immunosuppressed.

Further discussion should involve local Hepatologist and viral lab and consideration given
to further tests. The GP should be notified of the outcome of such discussions

Editorial Information

Last reviewed: 30/09/2022

Next review date: 30/09/2024

Author(s): West of Scotland Managed Clinical Network for Sexual Health Guidelines Group.

Version: 6.1

Author email(s): janice.allan@nhs.scot.

Approved By: West of Scotland Managed Clinical Network for Sexual Health