Isolated antibodies against the core antigen of hepatitis B virus in HIV‐infected patients

Abstract

SummaryThe aim of this study was to describe the frequency and significance of isolated antibodies against the hepatitis B virus (HBV) core antigen (HBc) in 2185 HIV-infected patients of the Aquitaine Cohort. Antibodies against HBc were found in 372 subjects (17%). Patients with isolated anti-HBc antibodies were more frequently coinfected with hepatitis C virus (HCV) (58.2%) than those who were anti-HB surface (HBs) antibody positive (22.9%, Po0.001) and those who were dually reactive anti-HBs/antiHBc antibody positive (27.3%, Po0.001). These results suggest interactions between HBV and HCV. As observed in patients not infected with HIV, the 'anti-HBc-alone' serological profile could reflect essentially late immunity with undetectable anti-HBs antibodies. However, an occult HBV infection cannot be ruled out.

Clinical significance of "anti-HBc alone" in human immunodeficiency virus-positive patients

“…This event has been previously reported in only one study [17] , in which a higher frequency of "anti-HBc alone" status was also found among women. Nevertheless, in our study the proportion of women in the "anti-HBc alone" group was the same as that in the past hepatitis group (30.9%).…”

“…Occult hepatitis prevalence data reported in "antiHBs alone" HIV-positive patients varies greatly from 0% to 89.5% [1][2][3]9,12,17,20,21] . However, in those studies that have found viral replication, detected viral load was usually very low (< 10 3 copies/mL) [3,20] .…”

Seroprevalence of Hepatitis B and C Viruses Among Children in Kilimanjaro Region, Tanzania

“…Both patients had detectable HIV-1 RNA levels, although only at 235 and 285 copies/mL; 1 had a CD4-lymphocyte percentage below threshold for age (21%); and both were receiving 3TC-containing HAART for just over 1 year. The presence of isolated HBcAb is common among HIV-infected individuals and has been associated with the presence of concurrent HCV infection [32][33][34]. Whether the results for these 2 patients reflect immunity with undetectable HBsAb, occult HBV infection, or a false-positive HBcAb result is unclear.…”

“…Standard 3-dose HBV vaccine regimens confer protection in >95% of immunocompetent children [35], but HIVinfected children have lower seroconversion rates. Even when seroconversion does occur, attrition of antibody with time, even among the immunocompetent, is also possible [30][31][32][33]. Tanzania's national immunization program does not include a birth dose of hepatitis B vaccine, but rather a 3-dose regimen beginning at 4 weeks of life in conjunction with other routine vaccinations.…”

Implementation of Occult Hepatitis Screening in the Spanish Cohort of HIV-infected Pediatric Patients

“…However, the results are not conclusive since liver biopsy for HBV DNA intrahepatic detection was not performed, and children participating in the study showed a high median age and good clinical and immunological status, as good as those in similar studies. Thus, the interpretation of the HBV marker profile in the 6 patients with probable OBI in the present study remains controversial in terms of its being a surrogate marker for HBV/HIV coinfection, or possibly not in the event of additional immunosuppresion (144,152,157,160). …”