THE HEPATITIS SEROLOGIC FINDING ANTI-HBC ALONE, CIRCULATING VIRAL-DNAAND INTERPRETATION OF FINDINGS

The immunological finding ''anti-HBc alone'' (without HBsAg, without a nti-HBs) leaves open the question of the state of HBV infection it ref lects: a transitory stage of an uncomplicated, eventually prolonged bu t resolving infection, a chronic or a late state of immunity. A findin g of this kind is often observed in immunocomprimised individuals (e.g . patients on hemodialysis, drug addicts) but also occurs in up to 1% of the Swiss blood donor population. Of 8800 sera tested for HBV marke r in a diagnostic laboratory, 153 individuals showed ''anti-HBc alone' '. They were investigated for circulating hepatitis B desoxyribonuclei c acid (HBV-DNA) by polymerase chain reaction (PCR). 60 individuals (3 9%) showed a positive result. Also taking into consideration anamnesti c measurements of conventional HBV markers in 95 individuals and conse cutive testing for HBV-DNA in 50 individuals, the following conclusion s emerged: 1. A positive finding of HBV-DNS by PCR does not necessaril y prove an ongoing HBV infection, hence a negative result does not rul e it out. Therefore, the indication to test for this parameter is limi ted for routine use. 2. The finding of ''anti-HBc alone'' implies that a HBV-infection is still going on until proven otherwise. This not on ly might be of consequence for the individual involved, but also raise s the question of screening of blood donors and of pregnant women for anti-HBc.