Knöll Antje, Hartmann Arndt, Hamoshi Harald, Weislmaier Karin, Jilg Wolfgang
Institute of Medical Microbiology and Hygiene, University of Regensburg, D-93042 Regensburg, Germany.
World J Gastroenterol. 2006 Feb 28;12(8):1255-60. doi: 10.3748/wjg.v12.i8.1255.
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.
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.
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.
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.
调查德国南部一家大学医院未经过挑选的患者及员工群体中“单纯抗-HBc阳性”的流行情况及其临床意义。
在82个月的时间跨度内对所有呈现“单纯抗-HBc阳性”模式的个体进行登记。检测血清和肝脏样本中的HBV-DNA，并查阅临床病历。
在3004例抗-HBc阳性个体中，有552例为“单纯抗-HBc阳性”（占18.4%），这种模式在男性中的发生率（20.5%）高于女性（15.3%；P<0.001）。在545例“单纯抗-HBc阳性”个体中，44例（8.1%）血清中检测到HBV-DNA，在39例接受检测的患者中，16例（41.0%）石蜡包埋的肝组织中检测到HBV-DNA。HBV基因组的检测与肝脏损伤的生化、超声或组织学迹象之间无关联。38例患有肝硬化或原发性肝癌的“单纯抗-HBc阳性”患者至少还有一种其他危险因素。在所有“单纯抗-HBc阳性”个体中，20.4%存在HCV合并感染，这是与较差临床结局相关的唯一因素。
在HBV低流行地区，未发现有证据表明单纯HBV会导致“单纯抗-HBc阳性”个体出现严重肝损伤。给出了针对这些个体的管理建议。
