The seroepidemiology of isolated core antibody against hepatitis B among Taiwanese adults - A large hospital-based study

Abstract

This study aims to investigate the prevalence of isolated core antibodies against hepatitis B (IAHBc) in different birth cohorts using a large medical record database. Hepatitis B viral serological test data were collected from a chart cloud database at a medical center in Taiwan between January 2006 and December 2018. The data collected included birth year, sex, hepatitis B viral markers (HBsAg, anti-HBs or anti-HBc), and hepatitis B vaccination records. Enrolled patients were grouped according to their birth year into three categories:≤1986, 1987-1992, and≥1993, which correspond to no neonatal hepatitis B immunization, plasma-derived HB vaccine (PDHBV), and recombinant hepatitis B vaccine (RHBV), respectively. Prevalence of hepatitis B viral seromarkers, including IAHBc, was calculated by sex, age groups, and birth cohorts. Those who underwent repeated hepatitis B serology tests were included for further analysis to follow up their serostatus. A total of 117,335 adults with complete hepatitis B serologic data were analyzed. Among them, 6641 individuals (5.7%) were found to have IAHBc. The prevalence of IAHBc was 11.4%, 0.8%, and 0.3% among those born before 1986, between 1987 and 1992, and after 1992, respectively. Among the 690 subjects with repeated blood tests and complete hepatitis B serologic data, 551 cases (79.9%) remained IAHBc. The other cases included resolved infection status (13.9%), seronegativity for three HB seromarkers (3%), and carrier of hepatitis B virus (2.3%). The management of individuals with IAHBc should be tailored to their age, vaccination status, and risk factors for occult hepatitis B viral infection.