Can the serological status of “anti‐HBc alone” be considered a sentinel marker for detection of “occult” HBV infection?

Abstract

Some individuals have "occult" infection with hepatitis B virus (HBV), defined as presence of HBV genome in the serum or liver tissue without HBV surface antigen (HBsAg) in the serum. The aim of this study was to investigate whether serum antibodies against HBV core antigen in isolation ("anti-HBc alone") are a useful marker of "occult" HBV in patients with or without hepatitis C virus (HCV) infection. "Anti-HBc alone" was detected in the sera of 119/6,544 (1.8%) asymptomatic outpatients referred to the diagnostic laboratory for routine testing for viral hepatitis, 62/607 (10.2%) drug users, and 42/195 (21.5%) patients with hepatocellular carcinoma. Using three in-house nested-PCR amplification assays to detect HBV preS-S (S), precore-core (C), and Pol viral regions, respectively, "occult" HBV sequences were found in 9 of the 223 sera (4.0%) with "anti-HBc alone." The highest prevalence of "occult" HBV sequences (5.9%) was detected in "anti-HBV alone" sera of individuals referred to the diagnostic laboratory without HCV antibodies. Direct sequencing of all PCR products confirmed the specificity of the PCR reactions and revealed the predominance of HBV genotype D. The data presented in this study suggest that detection of "anti-HBc alone" could reflect unrecognized "occult" HBV infection and that physicians should consider investigating such patients with HBV molecular tests.

Occult hepatitis B virus infection among injecting drug users in the Central-West Region of Brazil

“…No similar reports from Brazil were available for comparative purposes, but the prevalence of occult HBV infection measured in this study was higher than that observed in a population of non-IDUs in the Central-West Region of Brazil (2.7%, CI 95%: 0.7-8.3) (Ferreira et al 2009). Nevertheless, the prevalence observed in this study is comparable to those observed in IDU populations Italy (3.2%, CI 95%: 0.5-12.1) (Vitale et al 2008) and Argentina (7.7%, CI 95%: 3.9-14.0) (Trinks et al 2008). It is, however, lower than those reported by Torbenson et al (2004) and Lin et al (2007) in Baltimore (45%, CI 95%: 37.6-52.5) and Taiwan (41.1%, CI 95%: 35.5-46.8), respectively.…”

“…HBV transmission in this population occurs through multiple pathways, including sexual transmission or exposure to contaminated blood through the sharing of needles, syringes or other injecting equipment (Alter 2003, Lugoboni et al 2009). To date, few studies have documented the prevalence of occult HBV infection in IDUs (Torbenson et al 2004, Lin et al 2007, Trinks et al 2008, Vitale et al 2008. Furthermore, no data are available regarding occult HBV infection rates among IDUs in Brazil.…”

Identification of Novel Recombinant Forms of Hepatitis B Virus Generated from Genotypes Ae and G in HIV-1-Positive Japanese Men Who Have Sex with Men

“…The primers were WA-L, WA-R, HBVnext, and AS2330 (WA-L, WA-R, and AS2330 have been described previously) (Table 1). 39,40 PCR products were electrophoresed in 1% agarose gels. The DNA bands were extracted and sequenced using the BigDye Terminator kit (Applied Biosystems, Foster, CA) and the following primers:…”

“…39,40 Nucleic acid sequencing was performed in a ABI3130 automated sequencer (Applied Biosystems). Nucleic acid sequence analysis was performed using BLAST, CLUSTAL W (DDBJ: DNA Data Bank of Japan), GENE-TYX-MAC Ver.…”

Molecular Characteristics of Occult Hepatitis B Virus from Blood Donors in Southeast China

“…HBV NAT is procedurally cumbersome and incurs high costs. Thus, given these constraints, the use of an anti-HBc alone (serum antibodies against HBV core antigen in isolation) as a marker for OBI was investigated in the study described here, given that it may be a possible marker of infection (27), with one study citing an OBI detection rate of between 5 and 10% for patients who tested positive for anti-HBc as the sole marker of HBV infection (4). The clinical epidemiology of blood donor OBIs is not known in China, and the present study attempted to determine the clinical and molecular characteristics of these infections in the context of other cohorts of HBV carriers. ])…”