A 38-year-old woman who works as a nurse at a large community hospital is undergoing evaluation following an accidental needlestick in the operating room. The patient being operated on is not known to have any infections. As part of her evaluation, the nurse has serologic testing for viral hepatitis. Laboratory results are as follows: Which of the following statements is most likely to be true regarding the nurse's viral status?

Question

A 38-year-old woman who works as a nurse at a large community hospital is undergoing evaluation following an accidental needlestick in the operating room.  The patient being operated on is not known to have any infections.  As part of her evaluation, the nurse has serologic testing for viral hepatitis.  Laboratory results are as follows:  Which of the following statements is most likely to be true regarding the nurse's viral status?

Quizplus · Accepted Answer

11ec160b_382d_f532_9249_c7cfb833d5c3_MD0001_00 This patient's laboratory studies are typical of hepatitis B vaccination. The hepatitis B vaccine is a safe and highly effective recombinant vaccine that contains HBsAg, a surface antigen that stimulates the production of anti-HBs in the host. Anti-HBs is a neutralizing antibody that prevents viral entry into cells. Therefore, individuals who receive the vaccination will develop immunity and be positive for anti-HBs but negative for HBsAg. In contrast to the vaccine, which only contains HBsAg, infection with hepatitis B virus (HBV) exposes patients to additional antigens. Hepatitis B core antigen (HBcAg) is found within the virus and on infected hepatocytes but does not circulate in the bloodstream. If this patient had actually experienced HBV infection, her anti-HBc would also be positive (Choice C). Hepatitis B e antigen (HBeAg) is involved in viral replication, and detection of HBeAg in the bloodstream implies high levels of viral replication and infectivity. (Choices B and E) Persistence of HBsAg in the bloodstream indicates chronic hepatitis. Patients with no circulating HBeAg, presence of anti-HBe, and low viral loads have a lower risk of disease progression and are less likely to transmit HBV. (Choice D) The presence of anti-hepatitis A virus (HAV) IgG suggests that this patient is protected from acute HAV infection. It is impossible to determine from the information given whether the anti-HAV IgG is due to previous infection or immunization with the hepatitis A vaccine. (Choice F) The hepatitis D virus (HDV) is replication defective and depends on the genetic information provided by HBV for replication. This individual is not infected with HBV (her HBsAg is negative) and therefore cannot be infected with HDV. Educational objective: Individuals who are successfully immunized against hepatitis B virus develop protective anti-HBs antibody. Individuals who recover from hepatitis B infection, however, have anti-HBs as well as anti-HBc antibodies. The presence of circulating HBsAg indicates active infection.

A 38-Year-Old Woman Who Works as a Nurse at a Large