Isolated antibody to hepatitis B core antigen in patients with chronic hepatitis C virus infection.
OBJECTIVE
To evaluate the prevalence of isolated anti-HBc in patients with chronic hepatitis C virus (HCV) infection, and its relation to disease severity.


METHODS
We screened all patients with chronic HCV infection referred to King Faisal Specialist Hospital and Research Center for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), and anti-HBc. One hundred and sixty nine patients who tested negative for both HBsAg and anti-HBs were included in this study.


RESULTS
Pathologically, 59 had biopsy-proven cirrhosis and 110 had chronic active hepatitis (CAH). Of these 169 patients, 85 (50.3%) tested positive for anti-HBc. Patients with CAH had significantly higher prevalence of isolated anti-HBc than patients with cirrhosis, 71 (64.5%) and 14 (23.7%) respectively (P < 0.001). Twenty-five patients were tested for HBV DNA by qualitative PCR. The test was positive in 3 of them (12%; occult HBV infection).


CONCLUSIONS
Isolated anti-HBc alone is common in Saudi patients with chronic HCV infection, and is significantly more common in those with CAH than those with cirrhosis. Therefore, a screening strategy that only tests for HBsAg and anti-HBs in these patients will miss a large number of individuals with isolated anti-HBc, who may be potentially infectious.
Helmy
Ahmed
A
Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia. ahsalem10@hotmail.com
Al-Sebayel
Mohammed-Ibrahim
MI
D000328:Adult; D000917:Antibody Formation; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000097:blood / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology / Q000302:isolation & purification*; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000208:ethnology / Q000276:immunology*; D006801:Humans; D008099:Liver / Q000276:immunology / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D012529:Saudi Arabia / Q000208:ethnology; D012720:Severity of Illness Index
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens