title: Predictors of the isolated hepatitis B core antibody pattern in HIV-infected and -uninfected men in the multicenter AIDS cohort study.
abstract: BACKGROUND
  The significance of hepatitis B core antibody (anti-HBc) without hepatitis B surface antigen (HBsAg) or hepatitis B surface antibody (anti-HBs) is unclear.
  
  
  METHODS
  This cohort study included men enrolled in the Multicenter AIDS Cohort to determine clinical and laboratory predictors of isolated anti-HBc.
  
  
  RESULTS
  A total of 2286 subjects (51% human immunodeficiency virus [HIV]-infected) were followed over 3.9 years. Overall, 16.9% (387) had at least 1 visit with isolated anti-HBc. The isolated anti-HBc pattern was stable 84% of the time, and transitioned to or from a pattern of past infection (anti-HBc and anti-HBs). Isolated anti-HBc was associated with HIV infection (odds ratio [OR], 2.19; 95% confidence interval [CI], 1.73-2.79) and hepatitis C virus (HCV; OR, 4.21; 95% CI; 2.99-5.91). The HCV association was stronger for chronic HCV infection (OR, 6.76; 95% CI, 5.08-8.99) than for cleared HCV (OR, 3.03; 95% CI, 1.83-5.03). HIV infection, chronic HCV, and cleared HCV infection all remained associated with isolated anti-HBc in multivariable models (OR, 1.74; 95% CI, 1.33-2.29; OR, 6.24; 95% CI, 4.62-8.42; and OR, 2.77; 95% CI, 1.65-4.66, respectively). Among HIV-infected subjects, highly active antiretroviral therapy was negatively associated (OR, 0.79; 95% CI, .66-.95) with isolated anti-HBc.
  
  
  CONCLUSIONS
  Isolated anti-HBc is associated with HIV and HCV coinfection, especially active HCV replication, and most commonly occurs as a transition to or from the pattern of natural immunity (anti-HBc and anti-HBs). The isolated anti-HBc pattern likely represents resolved HBV infection with low or undetected anti-HBs.
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, orrance, CA 90509, USA. mwitt@labiomed.org
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: Gunter
authors.initials: G
authors.lastname: Rieg
authors.forename: Eric C
authors.initials: EC
authors.lastname: Seaberg
authors.forename: Charles R
authors.initials: CR
authors.lastname: Rinaldo
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Thio
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D060085:Coinfection; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006509:Hepatitis B / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012698:Serologic Tests
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens