Rapid Communication
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 21, 2006; 12(27): 4406-4410
Published online Jul 21, 2006. doi: 10.3748/wjg.v12.i27.4406
Isolated antibody to hepatitis B core antigen in patients with chronic hepatitis C virus infection
Ahmed Helmy, Mohammed Ibrahim Al-Sebayel
Ahmed Helmy, Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia, and also affiliated to Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
Mohammed Ibrahim Al-Sebayel, Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Supported by a Grant from King Abdel-Aziz City for Science and Technology, Riyadh, Saudi Arabia
Correspondence to: Dr. Ahmed Helmy, Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, MBC: 72, PO Box: 3354, Riyadh 11211, Saudi Arabia. ahsalem10@hotmail.com
Telephone: +966-1-4424818 Fax: +966-1-4424817
Received: November 1, 2005
Revised: November 28, 2005
Accepted: December 23, 2005
Published online: July 21, 2006
Abstract

AIM: To evaluate the prevalence of isolated anti-HBc in patients with chronic hepatitis C virus (HCV) infection, and its relation to disease severity.

METHODS: We screened all patients with chronic HCV infection referred to King Faisal Specialist Hospital and Research Center for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), and anti-HBc. One hundred and sixty nine patients who tested negative for both HBsAg and anti-HBs were included in this study.

RESULTS: Pathologically, 59 had biopsy-proven cirrhosis and 110 had chronic active hepatitis (CAH). Of these 169 patients, 85 (50.3%) tested positive for anti-HBc. Patients with CAH had significantly higher prevalence of isolated anti-HBc than patients with cirrhosis, 71 (64.5%) and 14 (23.7%) respectively (P < 0.001). Twenty-five patients were tested for HBV DNA by qualitative PCR. The test was positive in 3 of them (12%; occult HBV infection).

CONCLUSION: Isolated anti-HBc alone is common in Saudi patients with chronic HCV infection, and is significantly more common in those with CAH than those with cirrhosis. Therefore, a screening strategy that only tests for HBsAg and anti-HBs in these patients will miss a large number of individuals with isolated anti-HBc, who may be potentially infectious.

Keywords: Cirrhosis; Chronic hepatitis; Dual infection; Co-infection; Hepatitis B screening; Super-infection