{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:51:19Z","timestamp":1775904679940,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti\u2010HBs) is an uncommon but clinically important serological pattern, with a reported prevalence ranging from 2.8% to 35.95%. This study aimed to evaluate the authenticity of this coexistence pattern and to investigate its underlying causes. A total of 300 sera co\u2010positive for HBsAg and anti\u2010HBs were incubated with recombinant HBsAg (rHBsAg) of the adw, adr, and ayw serotypes, as well as with pooled clinical HBsAg\u2010positive sera, to calculate the neutralization index (NI) of anti\u2010HBs. In parallel, the same co\u2010positive samples were incubated with pooled clinical anti\u2010HBs\u2013positive sera to determine the NI of HBsAg. Additionally, 180 sera from healthy individuals under 32 years of age with isolated anti\u2010HBs positivity were tested against adw and adr rHBsAg and pooled clinical HBsAg\u2010positive sera to establish neutralization thresholds. Among the 300 co\u2010positive samples, HBsAg was confirmed positive in 100%, and anti\u2010HBs was confirmed positive in 89.00% (267\/300). The prevalence of true coexistence decreased with increasing anti\u2010HBs concentrations: 91.55% in the 10.00\u201350.00\u2009mIU\/mL group, 86.11% in the 50.00\u2013100.00\u2009mIU\/mL group, and 76.92% in the\u2009&gt;\u2009100.00 mIU\/mL group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.025). In serotype analysis, 46.82% (125\/267) of anti\u2010HBs were neutralized by adw and adr rHBsAg but not by ayw rHBsAg. Another 49.44% (132\/267) could not be neutralized by any of the three rHBsAg preparations but were neutralized by pooled clinical sera. The proportion of truly anti\u2010HBs positive individuals was relatively high among co\u2010positive samples, and this proportion increased as anti\u2010HBs concentrations decreased. The coexistence of HBsAg and anti\u2010HBs may be attributed to coinfection with both ayr and common serotypes, or to post\u2010vaccination infection with ayw or ayr serotypes.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70862","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:09:13Z","timestamp":1772960953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of HBsAg and Anti\u2010HBs Coexistence: Authenticity and Contributing Factors"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3540-8379","authenticated-orcid":false,"given":"Hao","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Affiliated Hospital of North Sichuan Medical College Nanchong Sichuan China"},{"name":"Department of Laboratory Medicine North Sichuan Medical College Nanchong Sichuan China"},{"name":"Translational Medicine Research Center North Sichuan Medical College Nanchong Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingyong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Affiliated Hospital of North Sichuan Medical College Nanchong Sichuan China"},{"name":"Department of Laboratory Medicine North Sichuan Medical College Nanchong Sichuan China"},{"name":"Translational Medicine Research Center North Sichuan Medical College Nanchong Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liuyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Affiliated Hospital of North Sichuan Medical College Nanchong Sichuan China"},{"name":"Department of Laboratory Medicine North Sichuan Medical College Nanchong Sichuan China"},{"name":"Translational Medicine Research Center North Sichuan Medical College Nanchong Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqin","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine The Sixth People's Hospital of Yibin Yibin Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Affiliated Hospital of North Sichuan Medical College Nanchong Sichuan China"},{"name":"Department of Laboratory Medicine North Sichuan Medical College Nanchong Sichuan China"},{"name":"Translational Medicine Research Center North Sichuan Medical College Nanchong Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Affiliated Hospital of North Sichuan Medical College Nanchong Sichuan China"},{"name":"Department of Laboratory Medicine North Sichuan Medical College Nanchong Sichuan China"},{"name":"Translational Medicine Research Center North Sichuan Medical College Nanchong Sichuan China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00760-9"},{"key":"e_1_2_12_3_1","unstructured":"WHO \u201cGlobal Progress Report on HIV Viral Hepatitis and Sexually Transmitted Infections \u201d2021 https:\/\/www.who.int\/publications\/i\/item\/9789240027077."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2305.161477"},{"issue":"6","key":"e_1_2_12_5_1","first-page":"1534","article-title":"Strategy Vaccination Against Hepatitis B in China","volume":"11","author":"Liao X.","year":"2015","journal-title":"Human Vaccines & Immunotherapeutics"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.2028"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13337-011-0037-0"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000150411"},{"issue":"5","key":"e_1_2_12_9_1","first-page":"348","article-title":"Characterization and Distribution of Hepatitis B Virus Genotypes and Subtypes in 4 Provinces of China","volume":"22","author":"Xia G.","year":"2001","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"issue":"2","key":"e_1_2_12_10_1","first-page":"97","article-title":"The Immune Response Induced by Hepatitis B Virus Principal Antigens","volume":"3","author":"Huang C. 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