The underlying mechanisms for the 'anti-HBc alone' serological profile

Arch Virol. 2010 Feb;155(2):149-58. doi: 10.1007/s00705-009-0559-6. Epub 2009 Nov 29.


The serological pattern, "anti-HBc alone", characterized by the presence of antibodies against the core antigen of hepatitis B virus (anti-HBc) as the only marker of hepatitis B, is not rare in a diagnostic setting. Depending on the prevalence of HBV infection and the patient group investigated, 1-31% of positive anti-HBc results are isolated positive findings. Anti-HBc alone is frequently observed in intravenous drug addicts, HIV-infected individuals, patients who are coinfected with HBV and hepatitis C virus, and pregnant women. However, it is not clear how this profile should be interpreted. Several studies have shown that anti-HBc alone is not only compatible with acute and resolved HBV infection but also with chronic infection. The reasons for the lack of HBsAg and anti-HBs in anti-HBc-alone individuals are not clear, but several mechanisms and possibilities have been suggested that could explain this phenomenon, some of which are delineated in this article.

Publication types

  • Review

MeSH terms

  • Female
  • Hepatitis B / diagnosis*
  • Hepatitis B / immunology
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Core Antigens / immunology*
  • Humans
  • Male
  • Pregnancy


  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens