Serological pattern "anti-HBc alone": Report on a workshop

In areas with low hepatitis B virus (HBV) endemicity such as most parts of Europe and the United States "anti-HBc alone" is found in 10-20% of all ind ividuals with HBV markers, i.e., 1-4% of the population. In about 10% of th ese individuals HBV DNA is detected by PCR, the proportions varying greatly depending on the population studied, being highest in individuals coinfect ed with hepatitis C virus (HCV) (above 35%) and HIV (above 85%). A small pr oportion of individuals with "anti-HBc alone" are in the window phase of an HBV infection or in a stage of late HBV immunity. For the large proportion of these individuals this is not the case and they are thought to have an unresolved HBV-infection or a chronic infection in a late or "low grade" pr oductive state. Currently, limited studies have been performed concerning t he clinical aspects of individuals with "anti-HBc alone" and suspected chro nic HBV infection. The majority of these individuals seem to be healthy. So me chronic carriers with "anti-HBc alone," however, do present signs of chr onic hepatitis. individuals with "anti-HBc alone" are potentially infectiou s. This is exemplified by a few case reports of HBV transmission to sexual contacts, perinatal transmission between mother and newborns and in blood r ecipients. Recommendations are given in relation to both the diagnostic and therapeutic procedures in the individuals with "anti-HBc alone" and in the blood banking and transplantation services. J. Med. Virol 62:450-455, 2000 . (C) 2000 Wiley-Liss, Inc.