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Ask the Medical Expert Archives 2000-2004

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Miscarriage
June 2000

Q. I recently miscarried and lab results revealed Hepatitis B surface antigen. The test was repeated with the same result. A complete panel was done and showed only the surface antigen positive, not the core, envelope, or any antibodies. The panel was repeated and again only showed a positive surface antigen. After waiting a few more weeks, the panel was repeated, and I tested negative for all parts, including the surface antigen. Because I suspected lab error, the test was repeated one last time and it showed a negative surface antigen, but slightly detectable. An infectious disease specialist at this lab said that he had heard of this before, but that it was extremely rare. Some pregnant women cross-synthesize a protein that gives a false positive on the Hep B test. I heard from a nurse that the cross-sensitization of the protein can cause a miscarriage. Are you familiar with this at all?

A. This is a very tough question. I was not able to find anything specific to cross-sensitization and hepatitis B, but it has been known to happen in certain other cases (other diseases). Still, this really must be quite rare. Literally millions of women have been immunized against hepatitis B and gone on to have a healthy child. This means that IF there is this cross-sensitization, it must either be exceedingly rare (or at least rarely cause any problems).

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