Patients with Core Antibody—But No Surface Antigen .....

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Patients with Core Antibody—But No Surface Antigen or Antibodies—May Have Hidden Infections

Because the hepatitis B virus and its antigens mutate so easily, scientists are finding that lab tests they once relied upon to indicate whether an infection was “active” or “resolved” may not be accurate.

For example, historically doctors believed that if patients tested positive for the hepatitis B core antibody, that they had been infected at some point and had either cleared the infection and developed surface antibodies, or they had a chronic infection and tested positive for surface antigen (HBsAg).

But as tests become more refined, researchers are finding patients who test positive for the core antibody but have neither the surface antigen nor the surface antibody.

French researchers took on this challenge and screened 6,431 patients for surface antigens and antibodies and core antibodies. They identified 362 (5.6%) patients who had only the core antibody without either surface antigens or antibodies. (This group represented 24.8% of all patients who were core antibody-positive.)

HBV DNA was found in 10 of the 362 (2.8%) patients, indicating an active infection, and six of them had viral loads exceeding 10,000 copies/mL.

The researchers, writing in the October issue of the Journal of Viral Hepatitis, concluded that the presence of only the core antibody is an indicator that the patient may have HBV that can replicate without large amounts of detectable surface antigen, which is called “occult” or hidden hepatitis B.

Breastfeeding by HBV-Infected Mothers Pose No Risk to Babies
A study published in the Archives of Pediatrics and Adolescent Medicine confirms that breastfeeding by HBV-infected mothers does not transmit the infection to their babies.

Researchers reviewed 10 studies of 751 infants, born to HBV-infected mothers, who were breastfed and 873 infants who were not breastfed. All babies were immunized at birth.

They concluded that, “Breastfeeding after proper immunoprophylaxis (immunization) did not contribute to mother-to-child transmission of HBV.”

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