Hepatitis B Core Antibody: Role in Clinical Practice in 2020

Gish, Robert G.; Basit, Syed Abdul; Ryan, John L.; Dawood, Altaf; Protzer, Ulrike

doi:10.1007/s11901-020-00522-0

Cited by 22 publications

(17 citation statements)

References 94 publications

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“…As expected, both OBI carriers were seropositive and had anti-HBc antibodies; in addition, the OP038924 individual was positive for anti-HBs. It is evident that OBI is more likely to be found in people with anti-HBc positive but anti-HB-negative serology profiles [25,26], however, we found only 1 OBI positive case out of 19 samples in this group (Figure 1).…”

Section: Serology Number (%)mentioning

confidence: 62%

Low Risk of Occult Hepatitis B Infection among Vietnamese Blood Donors

et al. 2022

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Occult hepatitis B infection (OBI) is characterized by the presence of low levels of hepatitis B virus (HBV) DNA and undetectable HBsAg in the blood. The prevalence of OBI in blood donors in Asia ranges from 0.013% (China) to 10.9% (Laos), with no data available from Vietnam so far. We aimed to investigate the prevalence of OBI among Vietnamese blood donors. A total of 623 (114 women and 509 men) HBsAg-negative blood donors were screened for anti-HBc and anti-HBs by ELISA assays. In addition, DNA from sera was isolated and nested PCR was performed for the HBV surface gene (S); a fragment of the S gene was then sequenced in positive samples. The results revealed that 39% (n = 242) of blood donors were positive for anti-HBc, and 70% (n = 434) were positive for anti-HBs, with 36% (n = 223) being positive for both anti-HBc and anti-HBs. In addition, 3% of blood donors (n = 19) were positive for anti-HBc only, and 34% (n = 211) had only anti-HBs as serological marker. A total of 27% (n = 170) were seronegative for any marker. Two of the blood donors (0.3%) were OBI-positive and sequencing revealed that HBV sequences belonged to HBV genotype B, which is the predominant genotype in Vietnam.

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Section: Serology Number (%)mentioning

confidence: 62%

Low Risk of Occult Hepatitis B Infection among Vietnamese Blood Donors

et al. 2022

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“…In fact, the use of anti-HBc antibody as a surrogate marker for OBI has been adopted in previous clinical study and daily practice. [16][17][18] As discussed above, HBV reactivation has been well-described in HBsAg-positive patients undergoing immunosuppressive therapy. This phenomenon is now being increasingly recognized in OBI individuals receiving immunosuppressive therapy.…”

Section: Introductionmentioning

confidence: 93%

Risk of alanine aminotransferase flare in patients with previous hepatitis B virus exposure on biological modifier therapies—A population‐based study

Mak

Yip

et al. 2022

Liver International

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Background It is uncertain whether biological therapies would increase the risk of hepatitis among patients with past hepatitis B virus (HBV) infection. This study aimed to evaluate the risk of alanine aminotransferase (ALT) flare in patients with past HBV infection while using biological therapies. Methodology Patients who received biological therapies for ≥3 months from 2000 to 2019 were identified from a population‐based database in Hong Kong. Patients with past HBV infection were compared with a control group without prior HBV exposure. The primary endpoint was development of ALT flare within 5 years of starting biological therapies, defined as ALT >80 IU/L. Results There were 2471 and 2394 patients with and without past HBV infection respectively. There was a non‐significant increase in risk of ALT flare among the HBV‐exposed group (27.6% vs. 23.7%, p = .055). In multivariable analysis, using prednisolone‐equivalent dose of >20 mg daily, male sex and concomitant immunosuppressants were risk factors for ALT flare. The risk of ALT flare was significantly higher with anti‐CD20 when compared to other biological agents (36.1% vs. 14.5%, p < .01), but was not significantly different among anti‐tumour necrosis factor, anti‐cytokine, Janus kinase inhibitors and T cell/B cell inhibitors or anti‐integrin (15.2% vs. 14.6% vs. 11.7% vs. 11.1%, p = .82). Among patients with documented hepatitis B surface antigen seroreversion, 96% were on anti‐CD20. Conclusions Our study further supports the current suggestion of prophylactic anti‐viral before starting anti‐CD20 in HBV‐exposed patients. While other biological therapies appear to have a lower risk for ALT flare, this result needs further confirmation.

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“…After 2002, this test had a false-positive rate of 2/ 1000. 117 Even after HBsAg clearance following acute infection, nearly all anti-HBc-positive persons are thought to harbor persistent intranuclear covalently closed circular DNA (cccDNA), which can result in the reactivation of viral replication under certain conditions that usually involve immunosuppression with particular agents. 118 Anti-HBc-positive patients do not need vaccine boosting, and they need to be educated about their HBV reactivation risk with certain types of immunosuppressive agents (especially if anti-HBs-negative).…”

Section: Current Standard Recommendationsmentioning

confidence: 99%

An Evidence-based Practical Guide to Vaccination for Hepatitis B Virus

Jacobson

Brown

McMahon

et al. 2022

Journal of Clinical Gastroenterology

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The hepatitis B virus (HBV) is highly infectious, with over 292 million chronically infected people worldwide and up to 2.4 million in the United States. Following infection, clinically silent liver damage can ensue, but symptoms or signs of advanced disease, including cirrhosis and hepatocellular carcinoma, can take decades to emerge. HBV has the heaviest public health burden of all hepatitis viruses and has now surpassed other major communicable diseases (eg, HIV, diarrheal disease, malaria, tuberculosis) as a leading cause of death globally. Preventing transmission is essential, and efforts are in place to reinforce screening, vaccination, and routine follow-up. Three safe and effective vaccines are available in the United States and other countries for HBV prevention, and the benefits of vaccination in preventing infection and its sequelae have been substantiated. For the first time in over 25 years, a new Food and Drug Administration-approved vaccine is available that offers a high degree of immunogenicity after 2, rather than 3, injections. Persistent challenges include the underutilization of vaccination, choice of vaccine, incomplete vaccinations, varying needs in different populations, management of nonresponders or those with undocumented or incompletely documented vaccination courses, and questions about whether and when booster injections may be needed. A panel of US academic hepatologists with expertise and experience in preventing and managing HBV infection have collaborated to write this practical clinical paper intended to guide clinicians in vaccinating for HBV and address questions that regularly arise in the clinic.

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Hepatitis B Core Antibody: Role in Clinical Practice in 2020

Cited by 22 publications

References 94 publications

Low Risk of Occult Hepatitis B Infection among Vietnamese Blood Donors

Low Risk of Occult Hepatitis B Infection among Vietnamese Blood Donors

Risk of alanine aminotransferase flare in patients with previous hepatitis B virus exposure on biological modifier therapies—A population‐based study

An Evidence-based Practical Guide to Vaccination for Hepatitis B Virus

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