Prevalence Of anti-HBc Positivity Research Articles

Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: a cross-sectional study

ObjectivesThis study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia.DesignA population-based cross-sectional seroprevalence study combined...

Occult hepatitis B infections and anti-HBc prevalence at a resource-limited blood bank in Mexico.

To identify blood donors with occult hepatitis B infections (OBIs), determine the prevalence of antibody to hepatitis B core antigen (anti-HBc) positivity and estimate the impact of anti-HBc screening on donor deferral at CETS-Veracruz (Mexico). Hepatitis B virus infection is a major concern in transfusion medicine. Mexican regulations only mandate screening for hepatitis B surface antigen (HBsAg), and there are no requirements regarding testing for anti-HBc or use of a nucleic acid test (NAT). There is, therefore, limited information about the prevalence of anti-HBc positivity and occult hepatitis B among blood donors in Mexico. This retrospective study examined individuals who donated blood to CETS-Veracruz from June 2014 to June 2017. All donors were serologically examined according to Mexican health regulations, and the prevalence of anti-HBc positivity was determined. A NAT was used to identify individuals with OBIs. We analysed the data of 28 016 blood donors. Over 4 years, the average prevalence of anti-HBc positivity was 1.05%. The risk factors for anti-HBc positivity were low education and age over 50 years. There were nine donors with OBIs. The presence of donors with OBIs in CETS-Veracruz and other Mexican blood banks highlights the need to mandate the implementation of anti-HBc screening in Mexico.

Seroprevalence of Hepatitis B Virus among Adults at High Risk for HIV Transmission Two Decades after Implementation of Nationwide Hepatitis B Virus Vaccination Program in Taiwan

BackgroundSeroprevalence of hepatitis B virus (HBV) after implementation of universal neonatal HBV vaccination and catch-up vaccination programs remains rarely investigated among the adults who were born in the vaccination era (in or after 1986) and engaged in high-risk sexual behaviors.Materials and MethodsBetween 2006 and 2012, we determined HBV surface antigen ([HBsAg), anti-HBs, and HBV core antibody (anti-HBc), hepatitis C virus antibody (anti-HCV) and rapid plasma reagin titers among HIV-infected men who have sex with men (MSM) born during 1984–1985 (Group I: 244 persons) and those born in or after 1986 (Group II: 523), and HIV-uninfected MSM (Group III: 377) and heterosexuals (Group IV: 217) born in or after 1986. Prevalence and incidence of HBV infection were estimated and multivariate analysis was performed to identify factors associated with HBsAg positivity.ResultsCompared with Group I, Groups II-IV had a significantly lower prevalence of HBsAg positivity (7.8% vs 3.7%, 2.4%, and 3.2%, respectively); and the prevalence of anti-HBc positivity was also lower for Groups III and IV (30.3% vs. 19.6%, and 18.0%, respectively), but no difference was observed between Groups I and II (30.3% vs. 26.3%). In multivariate analysis, HBsAg positivity was significantly associated with syphilis (adjusted odds ratio, 2.990; 95% confidence interval, 1.502–5.953) and anti-HCV positivity (adjusted odds ratio, 3.402; 95% confidence interval, 1.091–10.614). In subjects of Group II with all-negative HBV markers at baseline, the incidence rate of HBsAg seroconversion was 0.486 episodes per 100 person-years; and for those who received combination antiretroviral therapy containing lamivudine and/or tenofovir, none developed HBsAg seroconversion during the follow-up.ConclusionsAmong the adults who were born in or after 1986 and engaged in high-risk sexual behaviors in Taiwan, neonatal HBV vaccination and catch-up vaccination programs conferred long-term protection against HBsAg seroconversion and HBsAg positivity was associated with syphilis and anti-HCV positivity.

Author’s Reply; Nucleic Acid Testing for the Detection of HBV DNA

: Dear Editor, First, we agree with Seto et al. regarding the impacts of the sensitivity of the detection methods of OBI (occult hepatitis B infection) prevalence but disagree regarding their idea on the lack of usefulness of anti-HBc screens. They have referred to Seo et al., who reported that the prevalence of anti-HBc positivity in Korea was 13.5%, whereas the prevalence of OBI was 0.016% (1). Anti-HBc is the first antibody that is produced against HBV and is the most stable antibody (2); hence, the presence of the antibody in individuals demonstrates introduction of HBV to the immune system via several mechanisms, including transfusion (3, 4). Therefore, it seems that the rate of OBI among anti-HBc-positive persons is more than the anti-HBc-negative blood donors (5). During blood screening programs, hepatitis B surface antigen (HBsAg) testing, followed by polymerase chain reaction (PCR) assays, will be the most accurate approach of identifying OBI, but some blood transfusion services are unable to use PCR (based on high costs). We have proposed applying anti-HBc as a screening test for blood transfusion services that are unable to use PCR to reduce the risk of PTH via OBI-infected blood and its components. Second, Seto et al. have presented a nice mechanism for the possible cause for cryptogenic HCC in endemic chronic hepatitis B regions. They have described a good, probable mechanism of undetectable virological HBV markers in tumor histology. These mechanisms should be examined in future studies.

Author’s Reply; Nucleic Acid Testing for the Detection of HBV DNA

Dear Editor, First, we agree with Seto et al. regarding the impacts of the sensitivity of the detection methods of OBI (occult hepatitis B infection) prevalence but disagree regarding their idea on the lack of usefulness of anti-HBc screens. They have referred to Seo et al., who reported that the prevalence of anti-HBc positivity in Korea was 13.5%, whereas the prevalence of OBI was 0.016% [1]. Anti-HBc is the first antibody that is produced against HBV and is the most stable antibody [2]; hence, the presence of the antibody in individuals demonstrates introduction of HBV to the immune system via several mechanisms, including transfusion [3],[4]. Therefore, it seems that the rate of OBI among anti-HBc-positive persons is more than the anti-HBc-negative blood donors [5]. During blood screening programs, hepatitis B surface antigen (HBsAg) testing, followed by polymerase chain reaction (PCR) assays, will be the most accurate approach of identifying OBI, but some blood transfusion services are unable to use PCR (based on high costs). We have proposed applying anti-HBc as a screening test for blood transfusion services that are unable to use PCR to reduce the risk of PTH via OBI-infected blood and its components. Second, Seto et al. have presented a nice mechanism for the possible cause for cryptogenic HCC in endemic chronic hepatitis B regions. They have described a good, probable mechanism of undetectable virological HBV markers in tumor histology. These mechanisms should be examined in future studies.

Author’s Reply; Nucleic Acid Testing for the Detection of HBV DNA

: Dear Editor, First, we agree with Seto et al. regarding the impacts of the sensitivity of the detection methods of OBI (occult hepatitis B infection) prevalence but disagree regarding their idea on the lack of usefulness of anti-HBc screens. They have referred to Seo et al., who reported that the prevalence of anti-HBc positivity in Korea was 13.5%, whereas the prevalence of OBI was 0.016% (1). Anti-HBc is the first antibody that is produced against HBV and is the most stable antibody (2); hence, the presence of the antibody in individuals demonstrates introduction of HBV to the immune system via several mechanisms, including transfusion (3, 4). Therefore, it seems that the rate of OBI among anti-HBc-positive persons is more than the anti-HBc-negative blood donors (5). During blood screening programs, hepatitis B surface antigen (HBsAg) testing, followed by polymerase chain reaction (PCR) assays, will be the most accurate approach of identifying OBI, but some blood transfusion services are unable to use PCR (based on high costs). We have proposed applying anti-HBc as a screening test for blood transfusion services that are unable to use PCR to reduce the risk of PTH via OBI-infected blood and its components. Second, Seto et al. have presented a nice mechanism for the possible cause for cryptogenic HCC in endemic chronic hepatitis B regions. They have described a good, probable mechanism of undetectable virological HBV markers in tumor histology. These mechanisms should be examined in future studies.

Nucleic Acid Testing for the Detection of HBV DNA

Dear Editor, We read with interest the article by Arababadi et al. [1], which highlights different and important areas of concern in the management of occult hepatitis B (OBI). There are two relevant issues worthy of discussion. First, the authors described the variable prevalence of OBI in different geographical regions worldwide. The laboratory assay used to detect OBI is an important determinant of its prevalence. Because of the low viremic state of patients, OBI may not be detected even when sensitive polymerase chain reaction (PCR) assays are employed. Results of a recent population study in our locality involving 13,034 blood donors showed the prevalence of OBI to be between 0.11% and 0.13% [2]. We used nucleic acid testing to detect hepatitis B virus (HBV) DNA, which has a detection limit (3.7 IU/mL) lower than that of most available PCR assays. Only studies using sensitive assays should be considered when implementing policies for screening blood donors. Although Arababadi et al. have suggested using an antibody against the hepatitis B core antigen (anti-HBc) for screening blood donors, there is a vast difference in the prevalence of serum anti-HBc positivity and OBI worldwide. For example, the preva-lence of anti-HBc positivity in Korea is 13.5%, whereas the prevalence of OBI in the same region is 0.016% [3]. Hence, in blood donor screening programs, hepatitis B surface antigen (HBsAg) testing followed by nucleic acid testing should be regarded as the most accurate approach for the detection of OBI. Second, the authors have suggested that OBI is a possible risk factor for hepatocellular carcinoma (HCC), but they have also commented that the underlying patho-genesis is unclear. Recently, an Asian study compared the tumorous and adjacent non-tumorous liver tissues from 33 cases of cryptogenic HCC and 28 of HCC with identifiable causes [4]. Both intrahepatic HBV DNA and HBV pregenomic RNA (pgRNA) were detected in 73% of the cases of cryptogenic HCC, albeit at levels lower than those detected in cases of HBV-related HCC. Hence, it is very likely that both persistent viral replication and viral integration play an important role in the pathogenesis of OBI-related HCC. The detection rate of intrahepatic HBV DNA was higher in the non-tumorous tissues than in the tumorous tissues; this finding is consistent with the hypothesis that tumorous tissues lack the optimal environment for HBV replication [5], which may affect the detection of OBI-related HCC. Therefore, in regions with a high prevalence of chronic hepatitis B, OBI should be considered as a possible cause of cryptogenic HCC even when HBV virologic markers are undetectable in tumor histological analysis.

Investigation of the HBV DNA in isolated hepatitis B core antibody positive blood donors

The aim of this study was to determine the prevalence of anti-HBc positivity and presence of HBV DNA from anti-HBc positive found donations that are living in the city of Sivas, in Turkey. A total of 987 voluntary blood donors, admitted to blood centre of Cumhuriyet University Hospital Sivas, (Turkey) between February to June 2008 were included in this study. Presence of Anti-HBc was screened in all serum samples. Positive samples for Anti-HBc were tested for the presence of anti-HBs then anti-HBs-positive samples were investigated for HBcIgM, HBeAg and anti-HBe. All of the HBV serological markers were tested in all serum samples using ELISA method. The presence of HBV-DNA was determined quantitatively in serum samples of cases with isolated anti-HBc by real-time PCR. Anti-HBc total was established as positive 209 (21.1%) of the 987 blood donors. The isolated anti-HBc positivity was 15.8% and HBV DNA positivity in the blood donors was 0.1%. In conclusion, the risk of HBV transmission by transfusion in blood centers can reduce by routine screening for anti-HBc in addition to HBsAg screening and then investigating of HBV DNA in anti-HBc positive samples. Key words: Blood donors, isolated anti-HBc, HBV DNA.

De novo hepatitis B after liver transplantation from hepatitis B core antibody–Positive donors in an area with high prevalence of anti-HBc positivity in the donor population

De novo hepatitis B after liver transplantation from hepatitis B core antibody–Positive donors in an area with high prevalence of anti-HBc positivity in the donor population