Hepatitis B Management: Screening, Vaccination, Treatment & Isolated Core Antibodies in HBV Pos Patients-Hepatitis B Management

Video Transcription

Video Summary

The webinar focused on hepatitis B management, especially screening, vaccination, and interpreting isolated total core antibody positivity. Dr. Min Kim reviewed CDC guidance: all adults 18+ should receive one-time hepatitis B screening using a triple panel—HBsAg, anti-HBs, and total anti-HBc. Pregnant women should be screened during each pregnancy. Vaccination is recommended for all adults 19–59 and for older adults with risk factors, and vaccine should not be delayed while waiting for screening results.<br /><br />Dr. Kim explained hepatitis B serologies, natural history, and the meaning of isolated core antibody, which can reflect resolved infection with low anti-HBs, occult infection, mutant strains, the serologic window period, passive antibody transfer in infants, or rare false positives. HBV DNA testing is important in immunosuppressed patients, those starting hepatitis C treatment, or when occult infection is suspected.<br /><br />Dr. Robert Gish then discussed clinical cases showing how isolated core antibody and even surface antigen-negative, DNA-positive cases can still represent active or occult hepatitis B and require specialist evaluation. He emphasized that management should be guided by DNA, liver enzymes, fibrosis assessment, and clinical context, not surface antigen alone. The speakers also noted that core-positive patients generally should not be revaccinated unless a false positive is proven.<br /><br />Overall, the webinar stressed universal screening, appropriate vaccination, careful interpretation of serologies, and linkage to care for patients at risk of reactivation or progressive liver disease.

Keywords

hepatitis B

HBV screening

triple panel

HBsAg

anti-HBs

total anti-HBc

hepatitis B vaccination

isolated core antibody

HBV DNA testing

occult hepatitis B