"Anti-HBc Alone" Reflects Occult Hepatitis B Infection

NEW YORK (Reuters Health) Apr 29 - Serum antibodies to hepatitis B virus (HBV) core antigen (anti-HBc) in isolation may serve as a marker of occult infection with HBV, according to a report in the April issue of the Journal of Medical Virology.

Occult HBV infection is defined as the presence of HBV DNA in blood or liver in the absence of detectable HBV surface antigen (HBsAg) in serum, the authors explain, and previous studies have associated occult HBV infection with the progression of chronic liver disease in patients infected with hepatitis C (HCV).

Dr. Francesco Vitale from Universita degli Studi di Palermo, Italy and colleagues evaluated the prevalence of isolated anti-HBc and its possible value as a serologic marker for detection of HBV DNA in HBsAg-negative/anti-HBc-positive patients with or without HCV infection.

The prevalence of "anti-HBc alone" was 1.8% among asymptomatic subjects, 10.2% among drug users, and 21.5% among patients with hepatocellular carcinoma, the authors report.

More than half the individuals with anti-HBc in isolation (57.4%) were anti-HCV positive, including more than 85% of drug users and hepatocellular carcinoma patients with isolated anti-HBc.

Four percent of the sera with anti-HBc alone contained HBV genomes, the researchers note, including 5.9% of those without HCV antibodies, 3.2% of drug users, and 4.8% of hepatocellular carcinoma patients.

"This serologic pattern could be useful for further clinical investigations," Dr. Vitale and colleagues conclude. "Surely, a definitive assessment of this serological pattern as a sentinel marker for 'occult HBV' would require molecular investigation of individuals without, as well as with, 'anti-HBc alone'."

"The ultimate goal is to define the infectivity and clinical consequences of persons with these atypical serologic and molecular patterns of HBV infection," they add.

J Med Virol 2008;80:577-582.

(Source: Medscape)