Hepatitis B — Worldwide/Unknown
The number of cases of “acute” hepatitis B in West Virginia is noteworthy. Distinction from reactivation of chronic hepatitis B is sometimes difficult since patients with chronic hepatitis B often have 7S IgM anti-HBc (vs 19S) circulating in their blood prior to reactivation that is below the detection limit of the IgM-specific anti-HBc assay (which begins at a dilution of approximately 1:2000). When they undergo a reactivation of the disease, however, the IgM level increases and becomes
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