乙型肝炎核心抗体：2020年在临床实践中的作用

StephenW

Hepatitis B Core Antibody: Role in Clinical Practice in 2020

    Robert G. Gish, Syed Abdul Basit, John Ryan, Altaf Dawood & Ulrike Protzer

Current Hepatology Reports volume 19, pages254–265(2020)Cite this article

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    A correction to this article is available online at https://doi.org/10.1007/s11901-020-00544-8.

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Abstract
Purpose of Review

It is crucial for clinicians to understand the need to screen for hepatitis B core antigen (anti-HBc status), proper interpretation of HBV biomarkers, and that “anti-HBc only” indicates HBV exposure, lifelong persistence of cccDNA with incomplete infection control, and potential risk for reactivation.
Findings

Many common misconceptions exist, including that tests for anti-HBc have high false-positive rates, that patients with anti-HBc alone or occult hepatitis B may profit from “vaccine boosting” to achieve immune control of HBV, and that anti-HBc(+)/anti-HBs(+) patients have cleared HBV when they have actually achieved immune control, while HBV persists in some hepatocytes and can reactivate.
Summary

This review breaks down several common misconceptions regarding anti-HBc with the most recent evidence. In addition, current best strategies for anti-HBc testing and interpretation are reviewed and summarized.

StephenW

乙型肝炎核心抗体：2020年在临床实践中的作用

    罗伯特·G·吉什（Robert G.

《现行肝病学报告》第19卷，第254–265页（2020），引用本文

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    可在https://doi.org/10.1007/s11901-020-00544-8上在线获取对本文的更正。

    本文已更新

抽象
审查目的

对于临床医生来说，了解筛查乙型肝炎核心抗原（抗-HBc状况），正确解释HBV生物标志物的必要性以及“仅抗-HBc”指示HBV暴露，cccDNA的终生持续性以及不完全的感染控制是至关重要的，以及重新激活的潜在风险。
发现

存在许多常见的误解，包括抗HBc检测的假阳性率高，单独使用抗HBc或隐匿性乙型肝炎的患者可能会从“疫苗加强”中获益以实现对HBV的免疫控制，而抗HBc（ +）/抗HBs（+）患者在实际达到免疫控制后便清除了HBV，而HBV仍存在于某些肝细胞中并可以重新激活。
概要

这项审查以最新证据分解了关于抗-HBc的几种常见误解。此外，对当前抗HBc检测和解释的最佳策略进行了综述和总结。

StephenW

https://link.springer.com/article/10.1007/s11901-020-00522-0