Top

Current Hepatology Reports

Published in:

Open Access 01-09-2020 | Hepatitis B | Hepatitis B (JK Lim, Section Editor)

Hepatitis B Core Antibody: Role in Clinical Practice in 2020

Authors: Robert G. Gish, Syed Abdul Basit, John Ryan, Altaf Dawood, Ulrike Protzer

Published in: Current Hepatology Reports | Issue 3/2020

Abstract

Purpose of Review

It is crucial for clinicians to understand the need to screen for hepatitis B core antigen (anti-HBc status), proper interpretation of HBV biomarkers, and that “anti-HBc only” indicates HBV exposure, lifelong persistence of cccDNA with incomplete infection control, and potential risk for reactivation.

Findings

Many common misconceptions exist, including that tests for anti-HBc have high false-positive rates, that patients with anti-HBc alone or occult hepatitis B may profit from “vaccine boosting” to achieve immune control of HBV, and that anti-HBc(+)/anti-HBs(+) patients have cleared HBV when they have actually achieved immune control, while HBV persists in some hepatocytes and can reactivate.

Summary

This review breaks down several common misconceptions regarding anti-HBc with the most recent evidence. In addition, current best strategies for anti-HBc testing and interpretation are reviewed and summarized.

Thomas DL. Global elimination of chronic hepatitis. N Engl J Med. 2019;380(21):2041–50. https://doi.org/10.1056/NEJMra1810477.CrossRefPubMed

Seto WK, Lo YR, Pawlotsky JM, Yuen MF. Chronic hepatitis B virus infection. Lancet. 2018;392(10161):2313–24. https://doi.org/10.1016/S0140-6736(18)31865-8.CrossRefPubMed

European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370–98. https://doi.org/10.1016/j.jhep.2017.03.021.CrossRef

Abbott Laboratories. ABBOTT PRISM HBcore list no. 6E66. 34–3831/R9 ABBOTT PRISM hepatitis B virus core antigen (E. coli, recombinant). Abbott Park, IL: Abbott Laboratories.

Ilboudo CM, Guest EM, Ferguson AM, Garg U, Jackson MA. Misleading hepatitis B testing in the setting of intravenous immunoglobulin. F1000Research. 2013;2:249. https://doi.org/10.12688/f1000research.2-249.v1.

Gessoni G, Beggio S, Barin P, Favarato M, Galli C, Valverde S, et al. Significance of anti-HBc only in blood donors: a serological and virological study after hepatitis B vaccination. Blood Transfus. 2014;12(Suppl 1):s63–8. https://doi.org/10.2450/2013.0227-12.CrossRefPubMedPubMedCentral

Grob P, Jilg W, Bornhak H, Gerken G, Gerlich W, Gunther S, et al. Serological pattern “anti-HBc alone”: report on a workshop. J Med Virol. 2000;62(4):450–5.CrossRef

Wang Q, Klenerman P, Semmo N. Significance of anti-HBc alone serological status in clinical practice. Lancet Gastroenterol Hepatol. 2017;2(2):123–34. https://doi.org/10.1016/S2468-1253(16)30076-0.CrossRefPubMed

•• Lok AS, Zoulim F, Dusheiko G, Ghany MG. Hepatitis B cure: from discovery to regulatory approval. Hepatology. 2017;66(4):1296–313. https://doi.org/10.1002/hep.29323. Important recent comprehensive review of occult HBV infection, including understanding of HBV serum markers such as anti-HBc.

10.

Raimondo G, Locarnini S, Pollicino T, Levrero M, Zoulim F, Lok AS, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol. 2019;71(2):397–408. https://doi.org/10.1016/j.jhep.2019.03.034.CrossRefPubMed

11.

Yuen MF, Wong DKH, Fung J, Ip P, But D, Hung I, et al. HBsAg seroclearance in chronic hepatitis B in Asian patients: replicative level and risk of hepatocellular carcinoma. Gastroenterology. 2008;135(4):1192–9.CrossRef

12.

Yuen M-F, Ahn SH, Chen D-S, Chen P-J, Dusheiko GM, Hou J-L, et al. Chronic hepatitis B virus infection: disease revisit and management recommendations. J Clin Gastroenterol. 2016;50(4):286–94.CrossRef

13.

Lai CL, Wong D, Ip P, Kopaniszen M, Seto WK, Fung J, et al. Reduction of covalently closed circular DNA with long-term nucleos(t)ide analogue treatment in chronic hepatitis B. J Hepatol. 2017;66(2):275–81. https://doi.org/10.1016/j.jhep.2016.08.022.CrossRefPubMed

14.

Revill P, Testoni B, Locarnini S, Zoulim F. Global strategies are required to cure and eliminate HBV infection. Nat Rev Gastroenterol Hepatol. 2016;13(4):239–48. https://doi.org/10.1038/nrgastro.2016.7.CrossRefPubMed

15.

Lucifora J, Protzer U. Attacking hepatitis B virus cccDNA--the holy grail to hepatitis B cure. J Hepatol. 2016;64(1 Suppl):S41–8. https://doi.org/10.1016/j.jhep.2016.02.009.CrossRefPubMed

16.

Liang TJ, Block TM, McMahon BJ, Ghany MG, Urban S, Guo JT, et al. Present and future therapies of hepatitis B: from discovery to cure. Hepatology. 2015;62(6):1893–908.CrossRef

17.

Wooddell CI, Yuen MF, Chan HL, Gish RG, Locarnini SA, Chavez D et al. RNAi-based treatment of chronically infected patients and chimpanzees reveals that integrated hepatitis B virus DNA is a source of HBsAg. Sci Transl Med. 2017;9(409). https://doi.org/10.1126/scitranslmed.aan0241.

18.

Revill PA, Chisari FV, Block JM, Dandri M, Gehring AJ, Guo H, et al. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol. 2019;4(7):545–58. https://doi.org/10.1016/S2468-1253(19)30119-0.CrossRefPubMedPubMedCentral

19.

McMahon BJ, Alward WL, Hall DB, Heyward WL, Bender TR, Francis DP, et al. Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis. 1985;151(4):599–603.CrossRef

20.

Yi P, Chen R, Huang Y, Zhou RR, Fan XG. Management of mother-to-child transmission of hepatitis B virus: propositions and challenges. J Clin Virol. 2016;77:32–9. https://doi.org/10.1016/j.jcv.2016.02.003.CrossRefPubMed

21.

Ganem D, Prince AM. Hepatitis B virus infection--natural history and clinical consequences. N Engl J Med. 2004;350(11):1118–29. https://doi.org/10.1056/NEJMra031087.CrossRefPubMed

22.

Hoofnagle JH. Serologic markers of hepatitis B virus infection. Annu Rev Med. 1981;32:1–11. https://doi.org/10.1146/annurev.me.32.020181.000245.CrossRefPubMed

23.

Park JW, Kwak KM, Kim SE, Jang MK, Kim DJ, Lee MS, et al. Differentiation of acute and chronic hepatitis B in IgM anti-HBc positive patients. World J Gastroenterol. 2015;21(13):3953–9. https://doi.org/10.3748/wjg.v21.i13.3953.CrossRefPubMedPubMedCentral

24.

Galli C, Orlandini E, Penzo L, Badiale R, Caltran G, Valverde S, et al. What is the role of serology for the study of chronic hepatitis B virus infection in the age of molecular biology? J Med Virol. 2008;80(6):974–9. https://doi.org/10.1002/jmv.21179.CrossRefPubMed

25.

Rodella A, Galli C, Terlenghi L, Perandin F, Bonfanti C, Manca N. Quantitative analysis of HBsAg, IgM anti-HBc and anti-HBc avidity in acute and chronic hepatitis B. J Clin Virol. 2006;37(3):206–12. https://doi.org/10.1016/j.jcv.2006.06.011.CrossRefPubMed

26.

Song JE, Kim DY. Diagnosis of hepatitis B. Ann Transl Med. 2016;4(18). doi:https://doi.org/10.21037/atm.2016.09.11.

27.

Zoulim F. New insight on hepatitis B virus persistence from the study of intrahepatic viral cccDNA. J Hepatol. 2005;42(3):302–8. https://doi.org/10.1016/j.jhep.2004.12.015.CrossRefPubMed

28.

Li X, Zhao J, Yuan Q, Xia N. Detection of HBV covalently closed circular DNA. Viruses. 2017;9(6). https://doi.org/10.3390/v9060139.

29.

Yang HC, Kao JH. Persistence of hepatitis B virus covalently closed circular DNA in hepatocytes: molecular mechanisms and clinical significance. Emerg Microbes Infect. 2014;3(9) e64:1–7. https://doi.org/10.1038/emi.2014.64.CrossRef

30.

Ponde RA, Cardoso DD, Ferro MO. The underlying mechanisms for the ‘anti-HBc alone’ serological profile. Arch Virol. 2010;155(2):149–58. https://doi.org/10.1007/s00705-009-0559-6.CrossRefPubMed

31.

Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560–99. https://doi.org/10.1002/hep.29800.CrossRefPubMedPubMedCentral

32.

Pan CQ, Duan Z, Dai E, Zhang S, Han G, Wang Y, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–34. https://doi.org/10.1056/NEJMoa1508660.CrossRefPubMed

33.

• Hoofnagle JH, Seeff LB, Bales ZB, Zimmerman HJ. Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen. N Engl J Med. 1978;298(25):1379-83. https://doi.org/10.1056/nejm197806222982502. Important study evaluating blood donation safety from occult HBV infection and the role of anti-HBc testing.

34.

Candotti D, Assennato SM, Laperche S, Allain JP, Levicnik-Stezinar S. Multiple HBV transfusion transmissions from undetected occult infections: revising the minimal infectious dose. Gut. 2018;68:313–21. https://doi.org/10.1136/gutjnl-2018-316490.CrossRefPubMed

35.

Taira R, Satake M, Momose S, Hino S, Suzuki Y, Murokawa H, et al. Residual risk of transfusion-transmitted hepatitis B virus (HBV) infection caused by blood components derived from donors with occult HBV infection in Japan. Transfusion. 2013;53(7):1393–404. https://doi.org/10.1111/j.1537-2995.2012.03909.x.CrossRefPubMed

36.

Tani Y, Aso H, Matsukura H, Tadokoro K, Tamori A, Nishiguchi S, et al. Significant background rates of HBV and HCV infections in patients and risks of blood transfusion from donors with low anti-HBc titres or high anti-HBc titres with high anti-HBs titres in Japan: a prospective, individual NAT study of transfusion-transmitted HBV. HCV and HIV infections Vox Sang. 2012;102(4):285–93. https://doi.org/10.1111/j.1423-0410.2011.01561.x.CrossRefPubMed

37.

Kiely P, Margaritis AR, Seed CR, Yang H. Hepatitis B virus nucleic acid amplification testing of Australian blood donors highlights the complexity of confirming occult hepatitis B virus infection. Transfusion. 2014;54(8):2084–91. https://doi.org/10.1111/trf.12556.CrossRefPubMed

38.

Kleinman SH, Kuhns MC, Todd DS, Glynn SA, McNamara A, DiMarco A, et al. Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti-HBc: implications for transfusion transmission and donor screening. Transfusion. 2003;43(6):696–704.CrossRef

39.

Velati C, Fomiatti L, Baruffi L, Piccinini V, Prati D, Reina A, et al. Criteria for hepatitis B virus screening and validation of blood components in Italy: the position of the SIMTI HBV working group. Blood Transfus. 2011;9(4):455–61. https://doi.org/10.2450/2011.0014-11.CrossRefPubMedPubMedCentral

40.

Allain JP, Hewitt PE, Tedder RS, Williamson LM. Evidence that anti-HBc but not HBV DNA testing may prevent some HBV transmission by transfusion. Br J Haematol. 1999;107(1):186–95.CrossRef

41.

• World Health Organization. Screening donated blood for transfusion-transmissible infections. https://www.who.int/bloodsafety/publications/bts_screendondbloodtransf/en/Important analysis from 10-year German surveillance program demonstrating importance of anti-HBc screening for blood supply safety.

42.

Houareau C, Offergeld R. Anti-HBc screening - is it worth the effort? Results of a 10-year surveillance programme covering more than 30 million donations in Germany. Vox Sang. 2019;114(5):459–66. https://doi.org/10.1111/vox.12781.CrossRefPubMed

43.

• Ye X, Li T, Shao W, Zeng J, Hong W, Lu L et al. Nearly half of Ultrio plus NAT non-discriminated reactive blood donors were identified as occult HBV infection in South China. BMC Infect Dis. 2019;19(1):574. https://doi.org/10.1186/s12879-019-4215-9. Japanese study identifying segment of anti-HBc positive blood which may be safe for donation based on anti-HBs titers.

44.

Hoshi Y, Hasegawa T, Yamagishi N, Mizokami M, Sugiyama M, Matsubayashi K, et al. Optimal titer of anti-HBs in blood components derived from donors with anti-HBc. Transfusion. 2019;59:2602–11. https://doi.org/10.1111/trf.15393.CrossRefPubMed

45.

Seiskari T, Lehtisaari H, Haapala AM, Aittoniemi J. From Abbott ARCHITECT anti-HBc to anti-HBc II--improved performance in detecting antibodies to hepatitis B core antigen. J Clin Virol. 2010;47(1):100–1. https://doi.org/10.1016/j.jcv.2009.11.010.CrossRefPubMed

46.

• Yuan Q, Song LW, Cavallone D, Moriconi F, Cherubini B, Colombatto P et al. Total hepatitis B core antigen antibody, a quantitative non-invasive marker of hepatitis B virus induced liver disease. PLoS One. 2015;10(6):e0130209. https://doi.org/10.1371/journal.pone.0130209. Large retrospective analysis from Taiwan identifying combination of seromarkers to predict HBsAg seroclearance among HBeAg-negative patients.

47.

Hu HH, Liu J, Chang CL, Jen CL, Lee MH, Lu SN, et al. Level of hepatitis B (HB) core antibody associates with seroclearance of HBV DNA and HB surface antigen in HB e antigen-seronegative patients. Clin Gastroenterol Hepatol. 2019;17(1):172–81 e1. https://doi.org/10.1016/j.cgh.2018.04.064.CrossRefPubMed

48.

Rehermann B, Ferrari C, Pasquinelli C, Chisari FV. The hepatitis B virus persists for decades after patients’ recovery from acute viral hepatitis despite active maintenance of a cytotoxic T-lymphocyte response. Nat Med. 1996;2(10):1104–8. https://doi.org/10.1038/nm1096-1104.CrossRefPubMed

49.

Vandepapeliere P, Lau GK, Leroux-Roels G, Horsmans Y, Gane E, Tawandee T, et al. Therapeutic vaccination of chronic hepatitis B patients with virus suppression by antiviral therapy: a randomized, controlled study of co-administration of HBsAg/AS02 candidate vaccine and lamivudine. Vaccine. 2007;25(51):8585–97. https://doi.org/10.1016/j.vaccine.2007.09.072.CrossRefPubMed

50.

Xu DZ, Wang XY, Shen XL, Gong GZ, Ren H, Guo LM, et al. Results of a phase III clinical trial with an HBsAg-HBIG immunogenic complex therapeutic vaccine for chronic hepatitis B patients: experiences and findings. J Hepatol. 2013;59(3):450–6. https://doi.org/10.1016/j.jhep.2013.05.003.CrossRefPubMed

51.

Shouval D, Roggendorf H, Roggendorf M. Enhanced immune response to hepatitis B vaccination through immunization with a pre-S1/pre-S2/S vaccine. Med Microbiol Immunol. 2015;204(1):57–68. https://doi.org/10.1007/s00430-014-0374-x.CrossRefPubMedPubMedCentral

52.

Kosinska AD, Bauer T, Protzer U. Therapeutic vaccination for chronic hepatitis B. Curr Opin Virol. 2017;23:75–81. https://doi.org/10.1016/j.coviro.2017.03.011.CrossRefPubMed

53.

Paul S, Dickstein A, Saxena A, Terrin N, Viveiros K, Balk EM, et al. Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: a meta-analysis. Hepatology. 2017;66(2):379–88. https://doi.org/10.1002/hep.29082.CrossRefPubMedPubMedCentral

54.

O'Brien SF, Fearon MA, Yi QL, Fan W, Scalia V, Muntz IR, et al. Hepatitis B virus DNA-positive, hepatitis B surface antigen-negative blood donations intercepted by anti-hepatitis B core antigen testing: the Canadian blood services experience. Transfusion. 2007;47(10):1809–15. https://doi.org/10.1111/j.1537-2995.2007.01396.x.CrossRefPubMed

55.

Zhu HL, Li X, Li J, Zhang ZH. Genetic variation of occult hepatitis B virus infection. World J Gastroenterol. 2016;22(13):3531–46. https://doi.org/10.3748/wjg.v22.i13.3531.CrossRefPubMedPubMedCentral

56.

Raimondo G, Allain JP, Brunetto MR, Buendia MA, Chen DS, Colombo M, et al. Statements from the Taormina expert meeting on occult hepatitis B virus infection. J Hepatol. 2008;49(4):652–7. https://doi.org/10.1016/j.jhep.2008.07.014.CrossRefPubMed

57.

Lusida MI, Surayah, Sakugawa H, Nagano-Fujii M, Soetjipto, Mulyanto et al. Genotype and subtype analyses of hepatitis B virus (HBV) and possible co-infection of HBV and hepatitis C virus (HCV) or hepatitis D virus (HDV) in blood donors, patients with chronic liver disease and patients on hemodialysis in Surabaya, Indonesia. Microbiol Immunol 2003;47(12):969–975. https://doi.org/10.1111/j.1348-0421.2003.tb03457.x.

58.

Joller-Jemelka HI, Wicki AN, Grob PJ. Detection of HBs antigen in “anti-HBc alone” positive sera. J Hepatol. 1994;21(2):269–72.CrossRef

59.

Sugg U, Erhardt S, Schneider W. Chronic “low-level” hepatitis B virus carrier with probable infectivity. Lancet. 1982;1(8269):446–7.CrossRef

60.

• Lu H, Lok AS, Warneke CL, Ahmed S, Torres HA, Martinez F et al. Passive transfer of anti-HBc after intravenous immunoglobulin administration in patients with cancer: a retrospective chart review. The Lancet Haematology. 2018;5(10):e474-e8. https://doi.org/10.1016/S2352-3026(18)30152-2. Systematic review highlighting risk of HBV reactivation and need for prophylaxis among HBsAg-negative, anti-HBc-positive patients receiving immunosuppressive therapy.

61.

Terrault NA, Lok AS, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment and of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–99. https://doi.org/10.1002/hep.29800.CrossRefPubMedPubMedCentral

62.

Cholongitas E, Haidich AB, Apostolidou-Kiouti F, Chalevas P, Papatheodoridis GV. Hepatitis B virus reactivation in HBsAg-negative, anti-HBc-positive patients receiving immunosuppressive therapy: a systematic review. Ann Gastroenterol. 2018;31(4):480–90. https://doi.org/10.20524/aog.2018.0266.

63.

Schwaneck EC, Krone M, Kreissl-Kemmer S, Weissbrich B, Weiss J, Tony HP, et al. Management of anti-HBc-positive patients with rheumatic diseases treated with disease-modifying antirheumatic drugs-a single-center analysis of 2054 patients. Clin Rheumatol. 2018;37:2963–70. https://doi.org/10.1007/s10067-018-4295-8.CrossRefPubMed

64.

Perrillo RP, Gish R, Falck-Ytter YT. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):221–44 e3. https://doi.org/10.1053/j.gastro.2014.10.038.CrossRefPubMed

65.

Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT, American Gastroenterological Association I. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):215–9; quiz e16–7. doi:https://doi.org/10.1053/j.gastro.2014.10.039.

66.

Hwang JP, Artz AS, Somerfield MR. Hepatitis B virus screening for patients with cancer before therapy: American Society of Clinical Oncology provisional clinical opinion update. Journal of oncology practice. 2015;11(4):e487–9. https://doi.org/10.1200/JOP.2015.004846.CrossRefPubMed

67.

Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HL, Chen CJ, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016;10(1):1–98. https://doi.org/10.1007/s12072-015-9675-4.CrossRefPubMed

68.

Makvandi M. Update on occult hepatitis B virus infection. World J Gastroenterol. 2016;22(39):8720–34.CrossRef

69.

Lok AS, Everhart JE, Di Bisceglie AM, Kim H-Y, Hussain M, Morgan TR, et al. Occult and previous hepatitis B virus infection are not associated with hepatocellular carcinoma in United States patients with chronic hepatitis C. Hepatology. 2011;54(2):434–42. https://doi.org/10.1002/hep.24257.CrossRefPubMedPubMedCentral

70.

Food and Drug Administration. FDA drug safety communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C. 2006. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-risk-hepatitis-b-reactivating-some-patients-treated.

71.

Jakab SS. Liver and pancreatic cancer related to hepatitis B exposure: has the jury reached a verdict? J Clin Gastroenterol. 2014;48(8):655–6. https://doi.org/10.1097/mcg.0000000000000163.CrossRefPubMed

72.

Coppola N, Onorato L, Pisaturo M, Macera M, Sagnelli C, Martini S, et al. Role of occult hepatitis B virus infection in chronic hepatitis C. World J Gastroenterol. 2015;21(42):11931–40. https://doi.org/10.3748/wjg.v21.i42.11931.CrossRefPubMedPubMedCentral

73.

Mallet V, Vallet-Pichard A, Pol S. The impact of human immunodeficiency virus on viral hepatitis. Liver Int. 2011;31:135–9. https://doi.org/10.1111/j.1478-3231.2010.02394.x.CrossRefPubMed

74.

Mphahlele MJ, Lukhwareni A, Burnett RJ, Moropeng LM, Ngobeni JM. High risk of occult hepatitis B virus infection in HIV-positive patients from South Africa. J Clin Virol.35(1):14–20. https://doi.org/10.1016/j.jcv.2005.04.003.

75.

Fabbri G, Mastrorosa I, Vergori A, Mazzotta V, Pinnetti C, Grisetti S, et al. Reactivation of occult HBV infection in an HIV/HCV co-infected patient successfully treated with sofosbuvir/ledipasvir: a case report and review of the literature. BMC Infect Dis. 2017;17(1):182. https://doi.org/10.1186/s12879-017-2287-y.CrossRefPubMedPubMedCentral

76.

Neau D, Winnock M, Galpérine T, Jouvencel AC, Castéra L, Legrand E, et al. Isolated antibodies against the core antigen of hepatitis B virus in HIV-infected patients. HIV Med. 2004;5(3):171–3. https://doi.org/10.1111/j.1468-1293.2004.00206.x.CrossRefPubMed

77.

Firnhaber C, Viana R, Reyneke A, Schultze D, Malope B, Maskew M, et al. Occult hepatitis B virus infection in patients with isolated core antibody and HIV co-infection in an urban clinic in Johannesburg. South Africa Int J Infect Dis. 2009;13(4):488–92.CrossRef

78.

Michèle LP, Marielle G, Michel B, Henri D, Chavanet PP. Hepatitis B virus seroconversion in HIV-HBV coinfected patients treated with highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2000;23(4):356–7.CrossRef

79.

Chook JB, Teo WL, Ngeow YF, Tee KK, Ng KP, Mohamed R. Universal primers for detection and sequencing of hepatitis B virus genomes across genotypes A to G. J Clin Microbiol. 2015;53(6):1831–5. https://doi.org/10.1128/JCM.03449-14.CrossRefPubMedPubMedCentral

80.

Knöll A, Pietrzyk M, Loss M, Goetz WA, Jilg W. Solid-organ transplantation in HBsAg-negative patients with antibodies to HBV core antigen: low risk of HBV reactivation. Transplantation. 2005;79(11):1631–3.CrossRef

81.

Chazouilleres O, Mamish D, Kim M, Carey K, Wright T, Ferrell L et al. “Occult” hepatitis B virus as source of infection in liver transplant recipients. Lancet. 1994;343(8890):142–146, "Occult" hepatitis B virus as source of infection in liver transplant recipients.

82.

• Prieto M, Gómez MD, Berenguer M, Córdoba J, Rayón JM, Pastor M et al. De novo hepatitis B after liver transplantation from hepatitis B core antibody—positive donors in an area with high prevalence of anti-HBc positivity in the donor population. Liver Transpl. 2001;7(1):51-8. Retrospective analysis showing feasibility of HBcAb-positive liver grafts for transplantation.

83.

• Lei M, Yan LN, Yang JY, Wen TF, Li B, Wang WT et al. Safety of hepatitis B virus core antibody-positive grafts in liver transplantation: a single-center experience in China. World J Gastroenterol. 2018;24(48):5525-36. https://doi.org/10.3748/wjg.v24.i48.5525. Analysis of antiviral prophylaxis when transplanting anti-HBc-positive grafts for liver transplantation.

84.

Wong TC, Fung JY, Cui TY, Lam AH, Dai JW, Chan AC, et al. Liver transplantation using hepatitis B core positive grafts with antiviral monotherapy prophylaxis. J Hepatol. 2019;70(6):1114–22. https://doi.org/10.1016/j.jhep.2019.03.003.CrossRefPubMed

85.

Huprikar S, Danziger-Isakov L, Ahn J, Naugler S, Blumberg E, Avery RK, et al. Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management. Am J Transplant. 2015;15(5):1162–72. https://doi.org/10.1111/ajt.13187.CrossRefPubMed

86.

van de Laar TJ, Marijt-van der Kreek T, Molenaar-de Backer MW, Hogema BM, Zaaijer HL. The yield of universal antibody to hepatitis B core antigen donor screening in the Netherlands, a hepatitis B virus low-endemic country. Transfusion. 2015;55(6):1206–1213. https://doi.org/10.1111/trf.12962.

87.

Muselmani W, Habbal W, Monem F. Significance of screening antibodies to hepatitis B virus core antigen among Syrian blood donors. Transfus Med. 2013;23(4):265–8. https://doi.org/10.1111/tme.12043.CrossRefPubMed

88.

Ba Alawi F, Robertson PW, LePage AK, Jayamaha J, Baleriola C, Rawlinson WD. The reliability of HBV core antibody in serological screening for hepatitis B virus. Pathology. 2013;45(5):501–5. https://doi.org/10.1097/PAT.0b013e3283631cf9.CrossRefPubMed

89.

De Feo TM, Poli F, Mozzi F, Moretti MP, Scalamogna M. Risk of transmission of hepatitis B virus from anti-HBc positive cadaveric organ donors: a collaborative study. Transplant Proc.37(2):1238–9. https://doi.org/10.1016/j.transproceed.2004.12.041.

90.

Dickson RC, Everhart JE, Lake JR, Wei Y, Seaberg EC, Wiesner RH, et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database. Gastroenterology.113(5):1668–74. https://doi.org/10.1053/gast.1997.v113.pm9352871.

91.

Dodson SF, Issa S, Araya V, Gayowski T, Pinna A, Eghtesad B, et al. Infectivity of hepatic allografts with antibodies to hepatitis B virus. Transplantation. 1997;64(11):1582–4.CrossRef

92.

Saab S, Waterman B, Chi AC, Tong MJ. Comparison of different immunoprophylaxis regimens after liver transplantation with hepatitis B core antibody–positive donors: a systematic review. Liver Transpl. 2010;16(3):300–7.CrossRef

93.

Song LW, Liu PG, Liu CJ, Zhang TY, Cheng XD, Wu HL et al. Quantitative hepatitis B core antibody levels in the natural history of hepatitis B virus infection. Clin Microbiol Infect. 2015;21(2):197–203. https://doi.org/10.1016/j.cmi.2014.10.002.

94.

Li M-R, Lu J-H, Ye L-H, Sun X-L, Zheng Y-H, Liu Z-Q, et al. Quantitative hepatitis B core antibody level is associated with inflammatory activity in treatment-naïve chronic hepatitis B patients. Medicine (Baltimore). 2016;95(34):e4422. https://doi.org/10.1097/md.0000000000004422.CrossRef

95.

Fan R, Sun J, Yuan Q, Xie Q, Bai X, Ning Q, et al. Baseline quantitative hepatitis B core antibody titre alone strongly predicts HBeAg seroconversion across chronic hepatitis B patients treated with peginterferon or nucleos(t)ide analogues. Gut. 2016;65(2):313–20. https://doi.org/10.1136/gutjnl-2014-308546.CrossRefPubMed

96.

Matsubara T, Nishida T, Shimoda A, Shimakoshi H, Amano T, Sugimoto A, et al. The combination of anti-HBc and anti-HBs levels is a useful predictor of the development of chemotherapy-induced reactivation in lymphoma patients with resolved HBV infection. Oncol Lett. 2017;14(6):6543–52. https://doi.org/10.3892/ol.2017.7012.CrossRefPubMedPubMedCentral

97.

Puri P. Acute exacerbation of chronic hepatitis B: the dilemma of differentiation from acute viral hepatitis B. J Clin Exp Hepatol. 2013;3(4):301–12. https://doi.org/10.1016/j.jceh.2013.08.014.CrossRefPubMedPubMedCentral

98.

Dao DY, Hynan LS, Yuan H-J, Sanders C, Balko J, Attar N, et al. Two distinct subtypes of hepatitis B virus–related acute liver failure are separable by quantitative serum immunoglobulin M anti-hepatitis B core antibody and hepatitis B virus DNA levels. Hepatology. 2012;55(3):676–84. https://doi.org/10.1002/hep.24732.CrossRefPubMedPubMedCentral

Title: Hepatitis B Core Antibody: Role in Clinical Practice in 2020
Authors: Robert G. Gish
Syed Abdul Basit
John Ryan
Altaf Dawood
Ulrike Protzer
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Hepatitis B
Biomarkers
Published in: Current Hepatology Reports / Issue 3/2020
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00522-0

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Findings

Summary

Please log in to get access to this content

Other articles of this Issue 3/2020

Metabolic Targets in Nonalcoholic Steatohepatitis: Treating the Disease at the Metabolic Root

Role of Core/Capsid Inhibitors in Functional Cure Strategies for Chronic Hepatitis B

Point of Care Diagnostic Testing for Hepatitis B Virus

Prevention and Management of HBV in Organ Transplantation

Non-selective Beta-Blockers in Decompensated Cirrhosis

Budd-Chiari Syndrome: Anticoagulation, TIPS, or Transplant

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage