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AIM:To investigate the prevalence and clinical signifi-cance of“anti-HBc alone”in an unselected population ofpatients and employees of a university hospital in southernGermany.METHODS:All individuals with the pattern“anti-HBcalone”were registered over a time span of 82 mo.HBV-DNA was measured in serum and liver samples,andclinical 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%)moreoften than females(15.3%; P<0.001).HBV-DNA wasdetected in serum of 44 of 545“anti-HBc alone”individu-als(8.1%),and in paraffin embedded liver tissue in 16of 39 patients tested(41.0%).There was no associationbetween the detection of HBV genomes and the presenceof biochemical,ultrasonic or histological signs of liverdamage.Thirty-eight“anti-HBc alone”patients with cir-rhosis or primary liver carcinoma had at least one addi-tional risk factor.HCV-coinfection was present in 20.4%of all individuals with“anti-HBc alone”and was the onlyfactor associated with a worse clinical outcome.CONCLUSION:In an HBV low prevalence area,no evi-dence is found that HBV alone causes severe liver damagein individuals with“anti-HBc alone”.Recommendationsfor the management of these individuals are given.
AIM: To investigate the prevalence and clinical signifi-cance of “anti-HB alone” in an unselected population of patients and employees of a university hospital in southern Germany. METHODS: All individuals with the pattern “anti-HBcalone ” were registered Over a time span of 82 mo. HBV-DNA was measured in serum and liver samples, and clinically charts were reviewed .RESULTS: Five hundred and fifty two individuals were “anti-HBc alone” (of 3004 anti-HBc positive individuals; HBV-DNA wasdetected in serum of 44 of 545 “anti-HBc alone” individu-als (8.1%), and this pattern affected males (20.5%) moreoften than females There was no association between the detection of HBV genomes and the presenceof biochemical, ultrasonic or histological signs of liverdamage. Thirty-eight “anti-HBc alone” patients with cir-rhosis or primary liver carcinoma had at least one addi-tional risk factor. HCV-coinfection was present in 20.4% o f all individuals with “anti-HBc alone ” and was the onlyfactor associated with a worse clinical outcome. CONCLUSION: In an HBV low prevalence area, no evi-dence is found that HBV alone causes severe liver damage in individuals with “anti -HBc alone ”Recommendations for the management of these individuals are given.