PREVALENCE OF ANTI-HBC IN HBSAG-NEGATIVE POPULATION

SCREENING OF PATIENTS WITH UNSPECIFIED ACUTE HEPATITIS AND REVIEW OF THE LITERATURE

Authors

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

DOI:

https://doi.org/10.58395/pipd.v48i1.31

Keywords:

HBV, anti-HBc, acute hepatitis

Abstract

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.

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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

References

1. WHO Guidelines on hepatitis B and C testing. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
2. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015; 386(10003):1546-1555.
3. MacLachlan JH, Cowie BC. Hepatitis B virus epidemiology. Cold Spring Harb Perspect Med. 2015; 5(5):a021410.
4. Alter MJ. Epidemiology of hepatitis B in Europe and worldwide. J Hepatol. 2003; 39:S64–S69.
5. Teoharov P, Kevorkyan A. Principal hepatotropic viruses in Bulgaria: characteristics, diagnosis, incidence, specific prophylaxis, Sofia, 2014. [in Bulgarian]
6. Kurchatova A, Vladimirova N, Minkova A, Kamenov G, Stoitsova S, Parmakova K. Acute infectious diseases in Bulgaria in 2017 (Key Epidemiological Indicators). https://www.ncipd.org/index.php?option=com_docman&view=list&slug=analysis-2017&Itemid=1127&lang=bg
7. Ministry of Health 2006, Ordinance No. 21 on the Procedure for Registration, Reporting and Control of Infectious Diseases, http://www.mh.government.bg/media/filer_public/2015/04/17/naredba-21-ot-2005g-spisak-zarazni-bolesti-red-registratsia.pdf
8. Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP. Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiol Rev. 2006; 28:112-125.
9. Elgouhari H, Tamimi T, Carey W. Hepatitis B virus infection: Understanding its epidemiology, course, and diagnosis. Clev Clin J Med. 2008; 75(12):881-889.
10. Horvat RT. Diagnostic and Clinical Relevance of HBV Mutations. Lab Med. 2011; 42(8):488-496.
11. Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018; 67(No. RR-1):1-31.
12. Japhet MO, Adesina OA, Donbraye E, Adewumi MO. Hepatitis B core IgM antibody (anti-HBcIgM) among hepatitis B surface antigen (HBsAg) negative blood donors in Nigeria. Virol J. 2011; 8:513.
13. Karra VK, et al. Clinical Significance of Quantitative HBsAg Titres and its Correlation with HBV DNA Levels in the Natural History of Hepatitis B Virus Infection. J Clin Exp Hepatol. 2016; 6(3):209-215.
14. Dufour DR. Hepatitis B Surface Antigen (HBsAg) Assays—Are They Good Enough for Their Current Uses? Clin Chem. 2006; 52(8):1457-1459.
15. Trepo CG, et al. Hepatitis B antigen (HBsAg) and/or antibodies (anti-HBs and anti-HBc) in fulminant hepatitis: pathogenic and prognostic significance. Gut. 1976; 17(1):10-13.
16. Shimizu M, Ohyama M, Takahashi Y, et al. Immunoglobulin M antibody against hepatitis B core antigen for the diagnosis of fulminant type B hepatitis. Gastroenterology. 1983; 84:604-610.
17. Lau GK. How do we handle the anti-HBc positive patient? (in highly endemic settings). Clin Liver Dis. 2015; 5:29-31.
18. Jain M, Chakravarti A, Kar P. Clinical significance of isolated anti-HBc positivity in cases of chronic liver disease in New Delhi, India. J Glob Infect Dis. 2009; 1(1):29-32.
19. Pondé RAA, Cardoso DDP, Ferro MO. The underlying mechanisms for the ‘anti-HBc alone’ serological profile. Arch Virol. 2010; 155:149-158.
20. Chang JJ, Mohtashemi N, Bhattacharya D. Significance and Management of Isolated Hepatitis B Core Antibody (Anti-HBc) in HIV and HCV: Strategies in the DAA Era. Curr HIV/AIDS Rep. 2018; 15:172-181.
21. Wu T, Kwok RM, Tran TT. Isolated anti-HBc: The Relevance of Hepatitis B Core Antibody—A Review of New Issues. Am J Gastroenterol. 2017; 112:1780-1788.
22. Gerlich WH. Medical virology of hepatitis B: how it began and where we are now. Virol J. 2013; 10:239.
23. Gessoni G, Beggio S, Barin P, et al. Significance of anti-HBc only in blood donors: a serological and virological study after hepatitis B vaccination. Blood Transfus. 2014; 12(1):s63-s68.
24. Wedemeyer H, Cornberg M, Tegtmeyer B, Frank H, Tillmann HL and Manns MP. Isolated anti-HBV core phenotype in anti- HCV-positive patients is associated with hepatitis C virus replication. Clin Microbiol Infect. 2004; 10:70-72.
25. Mushahwar IK, Dienstag JL, Polesky HF, McGrath LC, Decker RH, Overby LR. Interpretation of Various Serological Profiles of Hepatitis B Virus Infection. Am J Clin Pathol. 1981; 76:773-777.
26. Ayoub WS, Martin P, Bhamidimarri KR. Hepatitis B Virus Infection and Organ Transplantation. Gastroenterol Hepatol. 2018; 14(1):33-40.

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Published

2020-05-12 — Updated on 2020-05-13

Versions

Issue

Vol. 48 No. 1 (2020)

Section

Articles

License

CC-BY 4.0

How to Cite

(1)
Ivanov, D.; Tenev, T.; Golkocheva-Markova, E. PREVALENCE OF ANTI-HBC IN HBSAG-NEGATIVE POPULATION: SCREENING OF PATIENTS WITH UNSPECIFIED ACUTE HEPATITIS AND REVIEW OF THE LITERATURE. Probl Infect Parasit Dis 2020, 48 (1), 33-38. https://doi.org/10.58395/pipd.v48i1.31.

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