An extensive study focusing on Korean American adults has shone a light on the prevalence and significance of the isolated hepatitis B core antibody (anti-HBc) in populations endemic for hepatitis B virus (HBV). The research, which was published in BMC Research Notes, revealed that an often overlooked serological marker, anti-HBc, is essential for accurately portraying HBV’s prevalence, understanding its exposure, and preventing potential reactivation in immunosuppressed individuals.
Background
Hepatitis B is a major global health concern, causing chronic liver disease and liver cancer in infected individuals. Serologic markers, including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc), are necessary for the diagnosis and monitoring of HBV infection. While HBsAg indicates active infection and anti-HBs signals immunity, anti-HBc is present in both current and past infections and can sometimes be the only detectable marker.
Key Findings
The study assessed 7,157 Korean American adults in New Jersey and discovered that 38.2% lacked anti-HBs, leaving them at risk of HBV. Out of these, 771 participants had anti-HBc, which might represent a past or chronic infection traditionally undetectable through standard screening processes which often test only for HBsAg and anti-HBs.
The prevalence of isolated anti-HBc was notably age-dependent, increasing steadily from 0.8% in the age group 21–30 to a startling 24.5% in those aged 71–91. This highlights the progressive exposure to HBV across the lifespan of individuals in this community.
Implications
The findings suggest that current HBV screening programs may overestimate the prevalence of the non-immune population while underestimating overall HBV prevalence. This is significant because it downplays the true risk of HBV reactivation, especially during periods of immunosuppression, such as when patients undergo chemotherapy or other forms of immunosuppressive therapy.
Reactivation of HBV can lead to severe consequences, including fulminant hepatitis, liver failure, and death. Thus, the authors of the study, led by Hyun Chul S, stress the importance of including the testing of anti-HBc in serologic screening protocols, with particular focus on populations at moderate to high risk for HBV infection.
Ethics and Approval
The study was conducted with adherence to the highest ethical standards and was approved by the Investigative Committee on Clinical Research (ICCR), the Institutional Review Board (IRB) of Holy Name Medical Center, Teaneck, NJ.
References
The report draws on a range of prior studies and guidelines, emphasizing the need for updated and thorough screening recommendations to better manage the risk of HBV, especially in endemic populations.
Keywords
1. HBV screening guidelines
2. Hepatitis B core antibody
3. Isolated anti-HBc prevalence
4. HBV reactivation risk
5. Endemic hepatitis B screening
The detailed findings of this landmark study can be accessed with the DOI: 10.1186/s13104-019-4287-z
This news article delves into a research study shedding light on the often-missed hepatitis B core antibody (anti-HBc) as a potential lone marker for HBV infection. Covering the implications for screening, the risks of overlooking anti-HBc, and the crucial aspect of age in HBV exposure prevalence, the article offers a comprehensive look at why anti-HBc inclusion in HBV screenings is essential for high-risk communities.
Conclusion
The study’s outcomes call for a reevaluation of current hepatitis B screening practices. Integrating the anti-HBc marker into routine tests could play a pivotal role in better protecting populations from the risks associated with undetected and unmanaged HBV infections. Due to the serious health implications that HBV poses, especially in high-risk communities, health authorities and medical practitioners must consider comprehensive screening that includes anti-HBc in their public health strategies.