Serological pattern "anti-HBc alone": characterization of 552 individuals and clinical significance.
OBJECTIVE
To investigate the prevalence and clinical significance of "anti-HBc alone" in an unselected population of patients and employees of a university hospital in southern Germany.


METHODS
All individuals with the pattern "anti-HBc alone" were registered over a time span of 82 mo. HBV-DNA was measured in serum and liver samples, and clinical charts were reviewed.


RESULTS
Five hundred and fifty two individuals were "anti-HBc alone" (of 3004 anti-HBc positive individuals; 18.4%), and this pattern affected males (20.5%) more often than females (15.3%; P<0.001). HBV-DNA was detected in serum of 44 of 545 "anti-HBc alone" individuals (8.1%), and in paraffin embedded liver tissue in 16 of 39 patients tested (41.0%). There was no association between the detection of HBV genomes and the presence of biochemical, ultrasonic or histological signs of liver damage. Thirty-eight "anti-HBc alone" patients with cirrhosis or primary liver carcinoma had at least one additional risk factor. HCV-coinfection was present in 20.4% of all individuals with "anti-HBc alone" and was the only factor associated with a worse clinical outcome.


CONCLUSIONS
In an HBV low prevalence area, no evidence is found that HBV alone causes severe liver damage in individuals with "anti-HBc alone". Recommendations for the management of these individuals are given.
Institute of Medical Microbiology and Hygiene, University of Regensburg, D-93042 Regensburg, Germany. antje.knoell@klinik.uni-regensburg.de
Antje
A
Knöll
Arndt
A
Hartmann
Harald
H
Hamoshi
Karin
K
Weislmaier
Wolfgang
W
Jilg
D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis / Q000097:blood; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008099:Liver / Q000737:chemistry / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D013997:Time Factors
D004279:DNA, Viral; D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral