Isolated anti-HBc: The Relevance of Hepatitis B Core Antibody-A Review of New Issues

• Published in: The American journal of gastroenterology Vol. 112; no. 12; pp. 1780 - 1788
• Main Authors: Wu, Tiffany, Kwok, Ryan M, Tran, Tram T
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01-12-2017
• Subjects: Antigens; Carcinoma, Hepatocellular - etiology; Coinfection - blood; Coinfection - diagnosis; Coinfection - therapy; Gastroenterology; Hepatitis; Hepatitis B; Hepatitis B - blood; Hepatitis B - diagnosis; Hepatitis B - therapy; Hepatitis B Antibodies - blood; Hepatitis B Core Antigens - blood; Hepatitis C - complications; Hepatitis C - diagnosis; Humans; Infections; Liver cancer; Liver Neoplasms - etiology
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1038/ajg.2017.397

Hepatitis B core antibody (anti-HBc) is considered the most sensitive serological marker for history of hepatitis B virus (HBV) infection. In a subset of anti-HBc carriers, anti-HBc is present in the absence of hepatitis B surface antigen and hepatitis B surface antibody-a serological pattern known as "isolated anti-HBc" (IAHBc). IAHBc has been of clinical interest over the past several years, with growing data to suggest its role as a serological marker for occult HBV infection (OBI). This article reviews the clinical significance and association of IAHBc with hepatitis C virus (HCV) co-infection, risk of HBV reactivation during direct-acting antiviral therapy for HCV as well as immune suppression, and development of hepatocellular carcinoma (HCC). Hepatitis B core-related antigen is also highlighted as an emerging laboratory assay that may identify OBI and predict HCC development in non-cirrhotic patients receiving nucleoside/nucleotide analog therapy.