Summary:
Hepatitis B core antibody (Anti HBc) is currently considered
the most sensitive serological marker for a patient’s history of
hepatitis B virus (HBV) infection given its long-term
persistence in the bloodstream. The serological pattern of
isolated Anti HBc (IAHBc) has been of clinical interest over
the past several years.,Thegrowing data of IAHBcsuggestingit
as a marker for occult HBV infection (OBI). Occult HBV
infection defined as HBV DNA detection in serum or the
liver by sensitive diagnostic tests in HBsAg negative
individuals with or without serologic markers of previous
viral exposure. OBI is especially concerned in blood
transfusion (BT), organ donation and reactivation of HBV
infection following immunosuppressive therapy. HBV
reactivation depends on viral and host factors. The important
clinical implications of IAHBcis in the setting of co-infection
with hepatitis C virus (HCV), reactivation risk of HBV during
directly acting anti viral (DAA) therapy in HCV infection
which may lead to progression of liver disease and
hepatocellular carcinoma (HCC). Antiviral prophylaxis has
been recommended in moderate to high risk of reactivation
prior to immunosuppressive and biologics. The main goal
of therapy is to improve survival and quality of life by
preventing disease progression and to prevent consequent
development of HCC. It is proposed to perform Anti-HBc test
as a screening test prior to blood transfusion,
HBVvaccination, DAA and immunosuppressive therapy in
addition to HBsAg screening test.
Keywords: Hepatitis B Virus; Hepatitis B virus DNA; Occult
hepatitis B virus infection; Hepatocellular carcinoma;
Hepatitis B surface antigen,;AntiHBc total; Bangladesh
(J Bangladesh Coll Phys Surg 2019; 37: 196-201)
DOI: http://dx.doi.org/10.3329/jbcps.v37i4.43350