Department of Laboratory Medicine, The East-West Neo Medical Center, School of Medicine, KyungHee University, Seoul, Korea.
J Med Virol. 2010 Sep;82(9):1508-14. doi: 10.1002/jmv.21862.
The "anti-HBc alone" is a frequent serological finding in clinical laboratories, making it difficult to determine whether the HBV infection has resolved. The objectives of this study were to investigate the prevalence of anti-HBc alone and HBV DNA detection (occult HBV infection) among anti-HBc alone, and to describe the demographic and clinical characteristics of anti-HBc alone. A total of 17,677 sera referred from the Health Promotion Center (HPC group, 4,014 sera) as well as all the hospital clinical departments (Patient group, 13,663 sera) were tested for HBs Ag, anti-HBc, and anti-HBs. HBV DNA test using real-time PCR was performed on 230 anti-HBc alone. The prevalence of anti-HBc alone was 8.9%, significantly higher in the Patient group than in the HPC group. The prevalence of anti-HBc was higher in men than women and was increased with age. Very low levels of HBV DNA were found in only 4 (1.7%) out of 230 subjects with anti-HBc alone. They were patients with conditions unrelated to chronic liver disease. Considering the high prevalence of anti-HBc alone, the frequency of occult HBV infection among anti-HBc alone was unexpectedly low. In addition, HBV viral load was low in these patients. Further studies are required to determine the clinical significance and infectivity of anti-HBc alone, in conjunction with very low levels of HBV DNA and to standardize the detection methodology for both anti-HBc alone and HBV DNA.
“单纯抗-HBc”是临床实验室中常见的血清学发现，这使得难以确定乙型肝炎病毒（HBV）感染是否已得到解决。本研究的目的是调查单纯抗-HBc 人群中抗-HBc 和 HBV DNA 检测（隐匿性 HBV 感染）的流行率，并描述单纯抗-HBc 的人口统计学和临床特征。共有 17677 份来自健康促进中心（HPC 组，4014 份血清）以及所有医院临床科室（患者组，13663 份血清）的血清样本用于检测 HBsAg、抗-HBc 和抗-HBs。对 230 份单纯抗-HBc 进行了实时 PCR 法的 HBV DNA 检测。单纯抗-HBc 的流行率为 8.9%，在患者组中明显高于 HPC 组。男性的抗-HBc 流行率高于女性，且随年龄增长而增加。仅在 230 份单纯抗-HBc 中有 4 份（1.7%）HBV DNA 水平极低，这些患者患有与慢性肝病无关的疾病。考虑到单纯抗-HBc 的高流行率，单纯抗-HBc 隐匿性 HBV 感染的频率出乎意料地低。此外，这些患者的 HBV 病毒载量较低。需要进一步研究来确定单纯抗-HBc 以及极低水平的 HBV DNA 的临床意义和传染性，并规范单纯抗-HBc 和 HBV DNA 的检测方法。
