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World J Gastroenterol. Feb 28, 2006; 12(8): 1255-1260
Published online Feb 28, 2006. doi: 10.3748/wjg.v12.i8.1255
Serological pattern “anti-HBc alone”: Characterization of 552 individuals and clinical significance
Antje Knöll, Arndt Hartmann, Harald Hamoshi, Karin Weislmaier, Wolfgang Jilg
Antje Knöll, Harald Hamoshi, Karin Weislmaier, Wolfgang Jilg, Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
Arndt Hartmann, Institute of Pathology, University of Regensburg, Regensburg, Germany
Author contributions: All authors contributed equally to the work.
Supported by the University of Regensburg, Germany, HWP grant for Antje Knöll
Correspondence to: Dr. Antje Knöll, Institute of Medical Microbiology and Hygiene, University of Regensburg, D-93042 Regensburg, Germany. antje.knoell@klinik.uni-regensburg.de
Telephone: +49-941-9446462 Fax: +49-941-9446402
Received: September 15, 2005
Revised: October 29, 2005
Accepted: October 26, 2005
Published online: February 28, 2006

AIM: To investigate the prevalence and clinical significance of “anti-HBc alone” in an unselected population of patients and employees of a university hospital in southern Germany.

METHODS: All individuals with the pattern “anti-HBc alone” were registered over a time span of 82 mo. HBV-DNA was measured in serum and liver samples, and clinical charts were reviewed.

RESULTS: Five hundred and fifty two individuals were “anti-HBc alone” (of 3004 anti-HBc positive individuals; 18.4%), and this pattern affected males (20.5%) more often than females (15.3%; P < 0.001). HBV-DNA was detected in serum of 44 of 545 “anti-HBc alone” individuals (8.1%), and in paraffin embedded liver tissue in 16 of 39 patients tested (41.0%). There was no association between the detection of HBV genomes and the presence of biochemical, ultrasonic or histological signs of liver damage. Thirty-eight “anti-HBc alone” patients with cirrhosis or primary liver carcinoma had at least one additional risk factor. HCV-coinfection was present in 20.4% of all individuals with “anti-HBc alone” and was the only factor associated with a worse clinical outcome.

CONCLUSION: In an HBV low prevalence area, no evidence is found that HBV alone causes severe liver damage in individuals with “anti-HBc alone”. Recommendations for the management of these individuals are given.

Keywords: HBV markers, HBV serology, Hepatitis B virus, Hepatocellular carcinoma, Occult HBV infection