Clinical significance of "anti-HBc alone" in human immunodeficiency virus-positive patients.
OBJECTIVE
To determine the prevalence and clinical relevance of isolated antibodies to hepatitis B core antigen as the only marker of infection ("anti-HBc alone") among human immunodeficiency virus (HIV) type-1 infected patients. Occult hepatitis B infection frequency was also evaluated.


METHODS
Three hundred and forty eight histories from 2388 HIV-positive patients were randomly reviewed. Patients with serological markers of hepatitis B virus (HBV) infection were classified into three groups: past hepatitis, "anti-HBc alone" and chronic hepatitis. Determination of DNA from HBV, and RNA and genotype from hepatitis C virus (HCV) were performed on "anti-HBc alone" patients.


RESULTS
One hundred and eighty seven (53.7%) HIV-positive patients had markers of HBV infection: 118 past infection (63.1%), 14 chronic hepatitis (7.5%) and 55 "anti-HBc alone" (29.4%). Younger age [2.3-fold higher per every 10 years younger; 95% confidence intervals (CI) 1.33-4.00] and antibodies to HCV infection [odds ratio (OR) 2.87; 95% CI 1.10-7.48] were factors independently associated with the "anti-HBc alone" pattern. No differences in liver disease frequency were detected between both groups. Serum levels of anti-HBs were not associated with HCV infection (nor viral replication or HCV genotype), or with HIV replication or CD4 level. No "anti-HBc alone" patient tested positive for HBV DNA.


CONCLUSIONS
"Anti-HBc alone" prevalence in HIV-positive patients was similar to previously reported data and was associated with a younger age and with antibodies to HCV infection. In clinical practice, HBV DNA determination should be performed only in those patients with clinical or analytical signs of liver injury.
Pérez-Rodríguez
Ma Teresa
MT
Infectious Diseases Unit, Internal Medicine Department, Xeral-Cíes University Hospital, 36204 Vigo, Spain. maite_perezes@yahoo.es
Sopeña
Bernardo
B
Crespo
Manuel
M
Rivera
Alberto
A
González del Blanco
Teresa
T
Ocampo
Antonio
A
Martínez-Vázquez
César
C
D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006678:HIV / Q000235:genetics; D006679:HIV Seropositivity / Q000276:immunology*; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies
D004279:DNA, Viral; D006512:Hepatitis B Core Antigens