Isolated Anti-HBc and Hepatitis B Virus Occult Infection

Occult hepatitis B virus infection and lamivudine‐resistant mutations in isolates from renal patients undergoing hemodialysis

“…Among patients positive for both anti‐HBs/anti‐HBc antibodies, the HBV‐DNA detection rate was much lower (2/18, 11%). These results are similar to those reported previously 31,33,34 , indicating that the anti‐HBc‐only serological pattern may be a more significant indicator of chronic HBV infection than of previous, resolved HBV infection.…”

“…The anti‐HBc‐only marker pattern is often interpreted as evidence of previous HBV infection with undetectable levels of anti‐HBs. Anti‐HBc only may also indicate undetectable levels of HBsAg in the blood of a chronic HBV carrier 31 . Reactivity that is limited to anti‐HBc is often observed in immunocompromised individuals, such as HIV‐infected patients, i.v.…”

Evidence that anti‐HBc but not HBV DNA testing may prevent some HBV transmission by transfusion

“…Previous studies have shown that not all HBsAg‐positive samples are found to contain HBV DNA by genomic amplification ( Mosley et al , 1995 ; Chung et al , 1993 ). Irrespective of the level of anti‐HBc, it was also shown previously that the frequency of HBV DNA in samples with isolated anti‐HBc from low‐risk groups such as blood donors were either negative ( Medrano et al , 1991 ; Aoki et al , 1993 ; Molijn et al , 1997 ; Douglas et al , 1993 ; Turner et al , 1997 ) or with a percentage of positivity ranging between 7% and 30% ( Mosley et al , 1995 ; Iizuka et al , 1992 ; Lai et al , 1989 ; Larsen et al , 1990 ). In contrast, individuals from high‐risk groups for HBV infection with isolated anti‐HBc tend to have higher frequency of HBV DNA ( Medrano et al , 1991 ; Sumazaki et al , 1989 ; Govindarajan et al , 1986 ).…”