Serological pattern "anti-HBc alone": characterization of 552 individuals and clinical significance

World J Gastroenterol. 2006 Feb 28;12(8):1255-60. doi: 10.3748/wjg.v12.i8.1255.


Aim: To investigate the prevalence and clinical significance of "anti-HBc alone" in an unselected population of patients and employees of a university hospital in southern Germany.

Methods: All individuals with the pattern "anti-HBc alone" were registered over a time span of 82 mo. HBV-DNA was measured in serum and liver samples, and clinical charts were reviewed.

Results: Five hundred and fifty two individuals were "anti-HBc alone" (of 3004 anti-HBc positive individuals; 18.4%), and this pattern affected males (20.5%) more often than females (15.3%; P<0.001). HBV-DNA was detected in serum of 44 of 545 "anti-HBc alone" individuals (8.1%), and in paraffin embedded liver tissue in 16 of 39 patients tested (41.0%). There was no association between the detection of HBV genomes and the presence of biochemical, ultrasonic or histological signs of liver damage. Thirty-eight "anti-HBc alone" patients with cirrhosis or primary liver carcinoma had at least one additional risk factor. HCV-coinfection was present in 20.4% of all individuals with "anti-HBc alone" and was the only factor associated with a worse clinical outcome.

Conclusion: In an HBV low prevalence area, no evidence is found that HBV alone causes severe liver damage in individuals with "anti-HBc alone". Recommendations for the management of these individuals are given.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • DNA, Viral / analysis
  • DNA, Viral / blood
  • Female
  • HIV Antibodies / blood
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Core Antigens / immunology*
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology
  • Hepatitis B virus / isolation & purification
  • Hepatitis B* / complications
  • Hepatitis B* / epidemiology
  • Hepatitis B* / immunology
  • Hepatitis B* / pathology
  • Hepatitis C Antibodies / blood
  • Humans
  • Liver / chemistry
  • Liver / pathology
  • Liver / virology
  • Liver Cirrhosis / complications
  • Liver Neoplasms / complications
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Prevalence
  • RNA, Viral / analysis
  • RNA, Viral / blood
  • Time Factors


  • DNA, Viral
  • HIV Antibodies
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis C Antibodies
  • RNA, Viral