The Significance of Isolated Antibody to Hepatitis B Core Antigen Seropositivity in Patients Infected with Human Immunodeficiency Virus

To decrease transmission of hepatitis B virus (HBV), immunization with the HBV vaccine has been recommended for individuals in high-risk populations who are seronegative for antibodies to hepatitis B. Isolated antibody to hepatitis B core antigen (anti-HBc) seropositivity is found in about 2.5% of v...

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Bibliographic Details
Published in:Clinical infectious diseases 1996-07, Vol.23 (1), p.189-190
Main Authors: Davaro, Raul E., Cheeseman, Sarah H., Keroack, Mark A., Ellison, Richard T.
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Antibodies
Biological and medical sciences
Brief Reports
Carrier State - immunology
Cross Reactions
Epidemiologic Factors
Female
Hepatitis
Hepatitis antigens
Hepatitis B
Hepatitis B - complications
Hepatitis B - epidemiology
Hepatitis B - immunology
Hepatitis B Antibodies - blood
Hepatitis B Core Antigens - immunology
Hepatitis B virus
HIV
HIV Infections - complications
HIV Infections - epidemiology
HIV Infections - immunology
human immunodeficiency virus
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Infectious diseases
Injections
Male
Massachusetts - epidemiology
Medical sciences
Serology
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Summary:To decrease transmission of hepatitis B virus (HBV), immunization with the HBV vaccine has been recommended for individuals in high-risk populations who are seronegative for antibodies to hepatitis B. Isolated antibody to hepatitis B core antigen (anti-HBc) seropositivity is found in about 2.5% of volunteer blood donors in the United States and is often considered a false-positive serological response. However, in a retrospective review of HIV-infected patients in Worcester, Massachusetts, we unexpectedly noted isolated anti-HBc seropositivity in >30% of our population. To gain insight into the meaning of the isolated anti-HBc seropositivity, we further analyzed this patient population. In our population, 44% of all individuals tested had isolated anti-HBc seropositivity, a rate at least 17 times the prevalence found in the general population in the United States. The finding that these individuals are more likely to belong to high risk groups for hepatitis B argues that the anti-HBc positivity is a true result and has several clinical implications. First, if isolated anti-HBc seropositivity is a marker for remote HBV infection, then these patients may not benefit from hepatitis B immunization. Second, these individuals may be a source for further HBV transmission if they are positive for HBsAg at a low level. Third, patients with AIDS who lose their anti-HBs are at risk for reactivation or reinfection with hepatitis B.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/23.1.189