Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2009; 15(10): 1237-1241
Published online Mar 14, 2009. doi: 10.3748/wjg.15.1237
Clinical significance of “anti-HBc alone” in human immunodeficiency virus-positive patients
Mª Teresa Pérez-Rodríguez, Bernardo Sopeña, Manuel Crespo, Alberto Rivera, Teresa González del Blanco, Antonio Ocampo, César Martínez-Vázquez
Mª Teresa Pérez-Rodríguez, Bernardo Sopeña, Alberto Rivera, Antonio Ocampo, César Martínez-Vázquez, Infectious Diseases Unit, Internal Medicine Department, Xeral-Cíes University Hospital, 36204 Vigo, Spain
Manuel Crespo, Infectious Diseases Department, Vall d’Hebron Hospital, 08035 Barcelona, Spain
Teresa González del Blanco, Microbiology Department, Xeral-Cíes University Hospital, 36204 Vigo, Spain
César Martínez-Vázquez, Bernardo Sopeña, Faculty of Medicine, University of Santiago de Compostela, 15705 Santiago de Compostela, A Coruña, Spain
Authors contributions: Pérez-Rodríguez MT, Sopeña B, González del Blanco T, Ocampo A, and Martínez-Vázquez C contributed equally to this work; Crespo M and Rivera A analyzed data.
Correspondence to: Mª Teresa Pérez-Rodríguez, Servicio de Medicina Interna, 11th Floor, Hospital Universitario Xeral-Cíes de Vigo, C/Pizarro 22. 36204-Vigo, Pontevedra, Spain.
Telephone: +34-986816000 (Ext 216073)
Fax: +34-986816029
Received: October 31, 2008
Revised: February 12, 2009
Accepted: February 19, 2009
Published online: March 14, 2009

AIM: To determine the prevalence and clinical relevance of isolated antibodies to hepatitis B core antigen as the only marker of infection (“anti-HBc alone”) among human immunodeficiency virus (HIV) type-1 infected patients. Occult hepatitis B infection frequency was also evaluated.

METHODS: Three hundred and forty eight histories from 2388 HIV-positive patients were randomly reviewed. Patients with serological markers of hepatitis B virus (HBV) infection were classified into three groups: past hepatitis, “anti-HBc alone” and chronic hepatitis. Determination of DNA from HBV, and RNA and genotype from hepatitis C virus (HCV) were performed on “anti-HBc alone” patients.

RESULTS: One hundred and eighty seven (53.7%) HIV-positive patients had markers of HBV infection: 118 past infection (63.1%), 14 chronic hepatitis (7.5%) and 55 “anti-HBc alone” (29.4%). Younger age [2.3-fold higher per every 10 years younger; 95% confidence intervals (CI) 1.33-4.00] and antibodies to HCV infection [odds ratio (OR) 2.87; 95% CI 1.10-7.48] were factors independently associated with the “anti-HBc alone” pattern. No differences in liver disease frequency were detected between both groups. Serum levels of anti-HBs were not associated with HCV infection (nor viral replication or HCV genotype), or with HIV replication or CD4 level. No “anti-HBc alone” patient tested positive for HBV DNA.

CONCLUSION: “Anti-HBc alone” prevalence in HIV-positive patients was similar to previously reported data and was associated with a younger age and with antibodies to HCV infection. In clinical practice, HBV DNA determination should be performed only in those patients with clinical or analytical signs of liver injury.

Keywords: Human immunodeficiency virus, “Anti-HBc alone”, Occult hepatitis, Hepatitis B virus DNA, Liver disease