ArticleEuropean journal of case reports in internal medicine2025
Unusual Concurrent HBsAg and Anti-HBs Positivity in Chronic Hepatitis B with Compensated Cirrhosis.
Article in European journal of case reports in internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The simultaneous positivity of hepatitis B surface antigen (HBsAg) and its corresponding antibody (anti-HBs) is a rare serological paradox in chronic hepatitis B. Its pathogenesis is not fully understood but may involve hepatitis B virus (HBV) S gene mutations leading to immune escape or complex host immune dysfunction. Recognizing this pattern is clinically important, as it may indicate advanced liver disease. Case report: A 54-year-old man with no history of alcohol abuse or liver disease presented with persistent bloating and dyspepsia. Laboratory tests revealed concurrent positivity for HBsAg (1438.5 S/Co) and anti-HBs (136.6 mIU/ml), hepatitis B e antigen (HbeAg) positivity, and a high HBV deoxyribonucleic acid (DNA) viral load (4.3 ×10 Conclusion: The concurrent positivity of HBsAg and anti-HBs is a rare serological finding that may reflect a complex HBV infection with a higher risk of progressive liver disease. This case illustrates that this unusual serological pattern can be associated with a high viral load and cirrhosis, highlighting the need for close monitoring of liver function, HBV DNA levels, and antiviral treatment response. LEARNING POINTS: Rare serological finding involving concurrent HBsAg and anti-HBs positivity in chronic hepatitis B with cirrhosis.Pattern that may indicate immune escape and active viral replication requiring closer clinical attention.Close monitoring of liver function, hepatitis B virus deoxyribonucleic acid levels, and antiviral treatment response is essential in such cases.
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