Hepatitis B Core Antibody: Role in Clinical Practice in 2020
- Purpose of Review: It is crucial for clinicians to understand the need to screen for hepatitis B core antigen (anti-HBc status), proper interpretation of HBV biomarkers, and that “anti-HBc only” indicates HBV exposure, lifelong persistence of cccDNA with incomplete infection control, and potential risk for reactivation.
- Findings: Many common misconceptions exist, including that tests for anti-HBc have high false-positive rates, that patients with anti-HBc alone or occult hepatitis B may profit from “vaccine boosting” to achieve immune control of HBV, and that anti-HBc(+)/anti-HBs(+) patients have cleared HBV when they have actually achieved immune control, while HBV persists in some hepatocytes and can reactivate.
- Summary: This review breaks down several common misconceptions regarding anti-HBc with the most recent evidence. In addition, current best strategies for anti-HBc testing and interpretation are reviewed and summarized.
- Keywords: Hepatitis B core antibody, Anti-HBc testing, HBV biomarkers, HBV screening, HBV reactivation