Latent HBV Infection

OCD

Is Common in Anti-HBc Patients

By Brian Boyle, MD


Chronic hepatitis B virus (HBV) infection has previously been shown in some patients who are negative for HBV surface antigen (HBsAg) but positive for antibodies to HBV core antigen (anti-HBc) at low titer. The overall prevalence of latent?HBV infection is not well known, however, and it is unclear whether a positive serum anti-HBc invariably reflects latent HBV infection.

In a study published in Hepatology Research, investigators from Japan correlated the presence of HBV DNA in liver tissue with serum anti-HBc and time course changes in serum anti-HBc titers in 33 donors and 30 recipients of liver transplantation. The investigators found that none of the anti-HBc-positive healthy donors or recipients was positive for HBV-DNA or anti-HBc at high titer (200 dilution) in their sera.

However, HBV-DNA was detected in the liver tissue of 24 of 33 healthy anti-HBc-positive donors (72.7%) and five of 30 anti-HBc-positive recipients (16.7%). Anti-HBc was found to be continuously positive in all healthy donors tested, while in 75% of recipients anti-HBc titers were transiently positive at the time of liver transplantation, but gradually decreased following transplantation and finally became negative after the mean follow up period of 9.0 months.

None of the recipients with transient anti-HBc had HBV-DNA detected in the liver.

The authors conclude, our findings suggested the possibility that presence of circulating anti-HBc does not always reflect the presence of HBV genomes in the liver tissue of anti-HBc-positive patients.? This is a confirmation of prior studies and clinicians should keep these data in mind when treating HBsAg negative, Anti-HBc positive patients.

03/28/03

Reference
A Katsuradaa and others. Circulating antibody to hepatitis B core antigen does NOT always reflect the latent hepatitis B virus infection in the liver tissue. Hepatology Research 2003;25:105-114.