Can the serological status of “anti-HBc alone” be considered a sentinel marker for detection of “occult” HBV infection?

Authors

  • Francesco Vitale,

    Corresponding author
    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
    • Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Università degli Studi di Palermo, Via del Vespro, 133, 90127 Palermo, Italy.
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  • Fabio Tramuto,

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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  • Ambrogio Orlando,

    1. Dipartimento di Medicina Generale, Pneumologia e Nutrizione Umana Università di Palermo, Azienda Ospedaliera “V. Cervello”, Palermo, Italy
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  • Giovanni Vizzini,

    1. Dipartimento di Medicina, Istituto Mediterraneo per i Trapianti e Terapie di Alta Specializzazione, U.P.M.C., Palermo, Italy
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  • Valentina Meli,

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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  • Giuseppe Cerame,

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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  • Walter Mazzucco,

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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  • Roberto Virdone,

    1. Dipartimento di Medicina Generale, Pneumologia e Nutrizione Umana Università di Palermo, Azienda Ospedaliera “V. Cervello”, Palermo, Italy
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  • Ugo Palazzo,

    1. Dipartimento di Medicina, Istituto Mediterraneo per i Trapianti e Terapie di Alta Specializzazione, U.P.M.C., Palermo, Italy
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  • Maria Rosaria Villafrate,

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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  • Alessandro Tagger,

    1. Dipartimento di Sanità Pubblica, Microbiologia e Virologia, Università degli Studi di Milano, Milano, Italy
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  • Nino Romano

    1. Dipartimento di Igiene e Microbiologia “G. D'Alessandro”, Sezione di Igiene, Università degli Studi di Palermo, Palermo, Italy
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Abstract

Some individuals have “occult” infection with hepatitis B virus (HBV), defined as presence of HBV genome in the serum or liver tissue without HBV surface antigen (HBsAg) in the serum. The aim of this study was to investigate whether serum antibodies against HBV core antigen in isolation (“anti-HBc alone”) are a useful marker of “occult” HBV in patients with or without hepatitis C virus (HCV) infection. “Anti-HBc alone” was detected in the sera of 119/6,544 (1.8%) asymptomatic outpatients referred to the diagnostic laboratory for routine testing for viral hepatitis, 62/607 (10.2%) drug users, and 42/195 (21.5%) patients with hepatocellular carcinoma. Using three in-house nested-PCR amplification assays to detect HBV preS-S (S), precore-core (C), and Pol viral regions, respectively, “occult” HBV sequences were found in 9 of the 223 sera (4.0%) with “anti-HBc alone.” The highest prevalence of “occult” HBV sequences (5.9%) was detected in “anti-HBV alone” sera of individuals referred to the diagnostic laboratory without HCV antibodies. Direct sequencing of all PCR products confirmed the specificity of the PCR reactions and revealed the predominance of HBV genotype D. The data presented in this study suggest that detection of “anti-HBc alone” could reflect unrecognized “occult” HBV infection and that physicians should consider investigating such patients with HBV molecular tests. J. Med. Virol. 80:577–582, 2008. © 2008 Wiley-Liss, Inc.

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