Jilg W, Sieger E, Zachoval R, Schätzl H
Max-von-Pettenkofer-Institute for Hygiene and Medical Microbiology, University of Munich, Germany.
J Hepatol. 1995 Jul;23(1):14-20. doi: 10.1016/0168-8278(95)80305-x.
BACKGROUND/AIMS: Several reports have unequivocally demonstrated that some individuals with antibodies against hepatitis B core antigen as the only serological marker for hepatitis B infection are chronic carriers of the hepatitis B virus. Nevertheless, conflicting data exist about the frequency of this phenomenon; its cause is unknown.
In a prospective study we tested individuals who were positive for anti-HBc alone for HBV-DNA as well as for coexisting infections with human immunodeficiency virus and hepatitis C virus.
Using polymerase chain reaction with primer pairs from three different regions of the hepatitis B virus genome, we found 54 of 164 individuals (32.9%) with anti-HBc alone to be positive for hepatitis B virus, the majority of them showing very low hepatitis B virus concentrations. 14.3% were human immunodeficiency virus positive; half of them were also hepatitis B virus carriers. Surprisingly, 62 of 153 participants (40.5%) in this study showed antibodies against hepatitis C virus, and about two thirds of the latter were also positive for HCV-RNA. This finding could be confirmed by a retrospective analysis of all people tested for hepatitis B virus markers and anti-HCV in our institution during the 2 years before the prospective study was begun. Again, a high correlation was found between the presence of anti-HCV and anti-HBc alone: 49.2% of individuals with anti-HBc only were anti-HCV positive also, compared to 26.8% of HBsAg carriers and only 10% of individuals showing the serological pattern of past hepatitis B.
Thus our study of individuals positive for anti-HBc alone revealed a high number of carriers of hepatitis B virus and hepatitis C virus among them; furthermore, we found some evidence that hepatitis C virus infection may favour this unusual hepatitis B virus marker pattern.
背景/目的：多项报告明确表明，一些仅以抗乙型肝炎核心抗原作为乙型肝炎感染唯一血清学标志物的个体是乙型肝炎病毒的慢性携带者。然而，关于这一现象的发生率存在相互矛盾的数据，其原因尚不清楚。
在一项前瞻性研究中，我们对仅抗-HBc呈阳性的个体进行了HBV-DNA检测，以及是否合并感染人类免疫缺陷病毒和丙型肝炎病毒的检测。
使用针对乙型肝炎病毒基因组三个不同区域的引物对进行聚合酶链反应，我们发现164例仅抗-HBc呈阳性的个体中有54例（32.9%）乙型肝炎病毒呈阳性，其中大多数人的乙型肝炎病毒浓度非常低。14.3%的个体人类免疫缺陷病毒呈阳性；其中一半也是乙型肝炎病毒携带者。令人惊讶的是，本研究的153名参与者中有62例（40.5%）显示抗丙型肝炎病毒抗体，其中约三分之二的人HCV-RNA也呈阳性。这一发现可以通过对前瞻性研究开始前两年内在我们机构进行乙型肝炎病毒标志物和抗-HCV检测的所有人的回顾性分析得到证实。同样，在仅抗-HCV和仅抗-HBc之间发现了高度相关性：仅抗-HBc的个体中有49.2%抗-HCV也呈阳性，相比之下，HBsAg携带者中这一比例为26.8%，而仅表现出既往乙型肝炎血清学模式的个体中这一比例仅为10%。
因此，我们对仅抗-HBc呈阳性个体的研究发现其中有大量乙型肝炎病毒和丙型肝炎病毒携带者；此外，我们发现了一些证据表明丙型肝炎病毒感染可能有利于这种不寻常的乙型肝炎病毒标志物模式。
