Perceived Significance of Isolated HBcAb in Patients with HIV: A Survey of Practitioners

Abstract

The prevalence of the isolated hepatitis B core Ab phenotype (hepatitis B surface antigen negative [HBsAg-] hepatitis B surface antibody negative [HBsAb-], and hepatitis B core antibody positive [HBcAb+] is particularly high among human HIV-positive patients. Controversy exists regarding both the significance of this phenotype and the risk of progressive liver disease as well as the need for hepatitis B vaccination in this population. A survey of 40 HIV primary care providers (PCPs) at an urban outpatient HIV clinic was conducted in 2005 regarding these two issues and a summary of the findings are presented in this report. Seventy-eight percent thought that these patients' infection had resolved and were immune, half thought they were at risk for progressive liver disease, and 6 (15%) routinely administered hepatitis B vaccine to patients with this phenotype. The wide variety in attitudes and practices among providers in a single clinic suggests the need for further research and development of management guidelines in this group of patients.

Positive hepatitis B virus core antibody in HIV infection—false positive or evidence of previous infection?

“…The interpretation of the significance of this finding varies. In a survey in 2005 of 40 HIV primary care providers at an urban HIV clinic in South Africa, 78% thought that an isolated anti‐HBc represented resolved infection and evidence of immunity, 50% thought these patients were at risk of progressive liver disease, and in 15% hepatitis B vaccine was given routinely [Thomas‐Gosain and Adeyemi, ].…”