Interpretation of hepatitis B virus serology results by medical scientists

Medical laboratory scientists who had agreed to participate in an evaluation which required them to measure the level of anti-HBs in a panel of sera, were given a brief clinical scenario for seven of the results and asked to comment on the person's immune status. The interpretations of immune status were assessed against the matters considered by the authors to reflect the current state of knowledge about immunity to hepatitis B and recommendations from authorities. There were a number of common but not universal misconceptions in the interpretation of results and current guidelines, particularly regarding appropriate use of hepatitis B immune globulin (HBIG), equating the absence of anti-HBs in a previous seroconverter with no immunity or the need to institute a new course of vaccination, and inappropriate recommendations for further testing or retesting. Given that the cost of serology for anti-HBs now exceeds the cost of three doses of vaccine, more effective and rational testing of immune status to hepatitis B is required.