• Daniel Ivanov Sofia University “St. Kliment Ohridski”
  • TenchoTenev, MD National Centre of Infectious and Parasitic Diseases
  • Assistant Professor Elica Golkocheva-Markova,PhD National Centre of Infectious and Parasitic Diseases


HBV, anti-HBc, acute hepatitis


Background. Among the various serological markers employed in the hepatitis B virus (HBV) differential laboratory diagnosis, serum HBsAg is considered the most reliable. In order to characterise the HBV infection, another important diagnostic marker is employed – the HBc antibody (anti-HBc). There are three categories of anti-HBc-positive individuals: patients with HBV immunity, patients with chronic HBV and individuals with the so-called isolated anti-HBc pattern. The current study aimed to evaluate the presence of anti-HBc in patients negative for HBsAg whose clinical diagnosis was acute viral hepatitis.

Material and methods. A total of 88 specimens were examined, of which 75 sera were from prospective patients diagnosed with acute viral hepatitis, and 13 sera from breast milk donors. Antibodies against the hepatitis B core antigen were detected by enzyme-linked immunosorbent assay (ELISA).

Results. Twenty-eight (32%) of all tested samples were positive for anti-HBc. Nineteen samples belonged to male and 9 to female patients. One positive sample was from a breast milk donor. Two age groups, namely 46-55 years and 56-65 years, demonstrated the highest rate of anti-HBc positivity. Among the other age groups positivity rates varied from 15% to 36%. The results demonstrated a linear trend of increasing anti-HBc prevalence with increasing age.

Conclusions. Considering the highest rate of anti-HBc positivity being demonstrated in the age range 46-65 years, it could be assumed that a sufficient number of risk factors accumulate over time resulting in greater population susceptibility to HBV infection.

Author Biographies

TenchoTenev, MD, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory “Hepatitis viruses”, Department of Virology

Assistant Professor Elica Golkocheva-Markova,PhD, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory “Hepatitis viruses”, Department of Virology


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2020-05-12 — Updated on 2020-05-13


How to Cite

Ivanov, D., Tenev, T., & Golkocheva-Markova, E. (2020). PREVALENCE OF ANTI-HBC IN HBSAG-NEGATIVE POPULATION: SCREENING OF PATIENTS WITH UNSPECIFIED ACUTE HEPATITIS AND REVIEW OF THE LITERATURE. PROBLEMS of Infectious and Parasitic Diseases, 48(1), 33–38. Retrieved from (Original work published May 12, 2020)




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