Detection of occult hepatitis B virus infection among subjects with isolated hepatitis B core antibodies: Results from a 3-year survey in an Italian tertiary-care hospital - 10/06/22

Highlights |
• | In the study population the seroprevalence is 4.6% for HBsAg and 11% for anti-HBcAg. |
• | The isolated anti-HBcAg status shows an age-dependent increase in Italians. |
• | Foreigners with isolated anti-HBcAg came mostly from Africa and Eastern Europe. |
• | HBV DNA assay is scarcely prescribed for subjects with isolated anti-HBcAg status. |
• | Among isolated anti-HBcAg subjects, 14.8% are positive for the prescribed HBV DNA. |
Abstract |
Background |
Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody.
Methods |
Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection.
Results |
The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections.
Conclusions |
The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
Le texte complet de cet article est disponible en PDF.Keywords : Isolated hepatitis B core antigen antibody, Hepatitis B virus DNA, Epidemiology, Immigrants, Occult hepatitis B virus infection, Laboratory diagnosis
Abbreviations : Anti-HBcAg, Anti-HBeAg, Anti-HBsAg, HBeAg, HBsAg, HBV, HCV, HIV, HIV-1, HIV-2, OBI, O.R., SD
Plan
Vol 46 - N° 5
Article 101892- mai 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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