Detection of occult hepatitis B virus infection among subjects with isolated hepatitis B core antibodies: Results from a 3-year survey in an Italian tertiary-care hospital

•In the study population the seroprevalence is 4.6% for HBsAg and 11% for anti-HBcAg.•The isolated anti-HBcAg status shows an age-dependent increase in Italians.•Foreigners with isolated anti-HBcAg came mostly from Africa and Eastern Europe.•HBV DNA assay is scarcely prescribed for subjects with iso...

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Published inClinics and research in hepatology and gastroenterology Vol. 46; no. 5; p. 101892
Main Authors De Conto, Flora, Buttrini, Mirko, Dell'Anna, Maria Loretana, Maccari, Clara, Montanari, Giulia, Arcangeletti, Maria Cristina, Martinelli, Monica, Chezzi, Carlo, Calderaro, Adriana
Format Journal Article
LanguageEnglish
Published France Elsevier Masson SAS 01.05.2022
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ISSN2210-7401
2210-741X
2210-741X
DOI10.1016/j.clinre.2022.101892

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Abstract •In the study population the seroprevalence is 4.6% for HBsAg and 11% for anti-HBcAg.•The isolated anti-HBcAg status shows an age-dependent increase in Italians.•Foreigners with isolated anti-HBcAg came mostly from Africa and Eastern Europe.•HBV DNA assay is scarcely prescribed for subjects with isolated anti-HBcAg status.•Among isolated anti-HBcAg subjects, 14.8% are positive for the prescribed HBV DNA. Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody. Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection. The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections. The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
AbstractList Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody. Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection. The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections. The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
•In the study population the seroprevalence is 4.6% for HBsAg and 11% for anti-HBcAg.•The isolated anti-HBcAg status shows an age-dependent increase in Italians.•Foreigners with isolated anti-HBcAg came mostly from Africa and Eastern Europe.•HBV DNA assay is scarcely prescribed for subjects with isolated anti-HBcAg status.•Among isolated anti-HBcAg subjects, 14.8% are positive for the prescribed HBV DNA. Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody. Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection. The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections. The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody.BACKGROUNDHepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody.Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection.METHODSBased on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection.The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections.RESULTSThe seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections.The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.CONCLUSIONSThe anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
ArticleNumber 101892
Author Buttrini, Mirko
Calderaro, Adriana
Arcangeletti, Maria Cristina
Maccari, Clara
De Conto, Flora
Chezzi, Carlo
Dell'Anna, Maria Loretana
Martinelli, Monica
Montanari, Giulia
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Issue 5
Keywords Anti-HBcAg
HIV-1
Anti-HBeAg
HIV-2
HBeAg
Isolated hepatitis B core antigen antibody
HBsAg
Epidemiology
Immigrants
Anti-HBsAg
SD
Occult hepatitis B virus infection
O.R
HIV
OBI
Laboratory diagnosis
HCV
Hepatitis B virus DNA
HBV
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Snippet •In the study population the seroprevalence is 4.6% for HBsAg and 11% for anti-HBcAg.•The isolated anti-HBcAg status shows an age-dependent increase in...
Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated...
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SubjectTerms Coinfection
DNA, Viral - analysis
Epidemiology
Female
Hepacivirus
Hepatitis B - diagnosis
Hepatitis B - epidemiology
Hepatitis B Antibodies
Hepatitis B Core Antigens
Hepatitis B Surface Antigens
Hepatitis B virus - genetics
Hepatitis B virus DNA
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - diagnosis
Hepatitis B, Chronic - epidemiology
HIV Infections
Humans
Immigrants
Isolated hepatitis B core antigen antibody
Laboratory diagnosis
Male
Occult hepatitis B virus infection
Seroepidemiologic Studies
Tertiary Care Centers
Title Detection of occult hepatitis B virus infection among subjects with isolated hepatitis B core antibodies: Results from a 3-year survey in an Italian tertiary-care hospital
URI https://www.clinicalkey.com/#!/content/1-s2.0-S2210740122000353
https://dx.doi.org/10.1016/j.clinre.2022.101892
https://www.ncbi.nlm.nih.gov/pubmed/35202845
https://www.proquest.com/docview/2633847304
Volume 46
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