Just to add on to the advice Dr Ti has provided, non-responders who have a strong family history of Hepatitis B carrier status should be aware of this entity known as "occult Hepatitis B" infection. This is a rare condition in which routine Hepatitis B surface protein test (aka HBsAg) is negative yet the person is actually a Hepatitis B carrier. This is the reason why repeated vaccination attempts will not induce antibody formation in that person since he or she is already infected with the virus.
A DNA test is necessary to reveal such a status which will show the presence of Hepatitis B virus in the blood stream. Such patients are usually diagnosed late as the routine tests fail to pick them up. The follow-up recommendation of such patients should be the same as any other Hepatitis B carrier with blood tests and liver ultrasound scans on a regular basis.
- Dr Quan
