Department of Laboratory Medicine, KyungHee University School of Medicine, Seoul, Korea,
Arch Virol. 2014 Feb;159(2):227-33. doi: 10.1007/s00705-013-1810-8. Epub 2013 Aug 10.
Serological detection of isolated anti-hepatitis B core antibody (anti-HBc) can occur in various scenarios, but the most clinically relevant situation is occult hepatitis B virus (HBV) infection (OBI). The purpose of this study was to evaluate the prevalence and clinical relevance of isolated anti-HBc and of OBI with isolated anti-HBc from an unselected hospital population. A total of 14,253 patients referred for hepatitis B surface antigen (HBsAg)/anti-HBs testing were classified into either the Health Promotion Center (HPC) group or the patient group. For patients who were negative for both HBsAg and anti-HBs, an anti-HBc test was additionally performed. An HBV DNA real-time PCR test was performed on isolated anti-HBc patients, and their demographic and clinical data were reviewed. The measured prevalence of isolated anti-HBc and OBI in isolated anti-HBc patients was 5.9 % and 4.7 %, respectively. Prevalence was higher in males, elderly people, and the patient group than in females, the younger, and the HPC group, respectively. In most cases, the levels of HBV DNA load were very low (less than 200 IU/mL), and most cases of OBI presented without liver disease or history of HBV infection. The prevalence of isolated anti-HBc and OBI are affected by the methods of detection, subject population, and constituent factors such as sex and age. Although detection of HBV DNA does not always indicate infectivity, highly sensitive standardized HBV DNA tests are needed in clinical settings to exclude the possibility of OBI, especially in the advanced age group.
血清学检测孤立抗乙型肝炎核心抗体（抗-HBc）可发生于各种情况下，但最具临床相关性的情况是隐匿性乙型肝炎病毒（HBV）感染（OBI）。本研究旨在评估来自未选择人群的医院患者中孤立抗-HBc和 OBI 的流行率和临床相关性。共 14253 例患者因乙型肝炎表面抗原（HBsAg）/抗-HBs 检测而就诊，分为健康促进中心（HPC）组和患者组。对于 HBsAg 和抗-HBs 均为阴性的患者，还进行了抗-HBc 检测。对孤立抗-HBc 患者进行了乙型肝炎病毒 DNA 实时 PCR 检测，并回顾了其人口统计学和临床数据。在孤立抗-HBc 患者中，孤立抗-HBc 和 OBI 的测量流行率分别为 5.9%和 4.7%。男性、老年人和患者组的流行率高于女性、年轻人和 HPC 组。在大多数情况下，HBV DNA 载量水平非常低（低于 200IU/mL），大多数 OBI 病例无肝病或 HBV 感染史。孤立抗-HBc 和 OBI 的流行率受检测方法、研究对象人群以及性别和年龄等构成因素的影响。虽然 HBV DNA 的检测并不总是提示感染性，但在临床环境中需要使用高度敏感的标准化 HBV DNA 检测来排除 OBI 的可能性，尤其是在高龄人群中。
