Evaluation of Isolated Anti-HBc Positivity in Patients Considered for Hepatitis B Diagnosis: 8.5 Years of Data

Background: Hepatitis B virus (HBV) infection is a global health problem. Isolated anti-hepatitis B core (HBc) serologic pattern is the most common atypical serologic profile and is defined as positive anti-HBc and negative hepatitis B surface antigen (HBsAg) and anti-HBs. Objectives: This study aimed to determine the prevalence of isolated anti-HBc positivity in samples sent to the medical microbiology laboratory for the examination of hepatitis B indicators, to identify both anti-HBc IgM and HBV DNA positivity rates within this pattern, to examine the relationship of this atypical pattern with different clinics, and to contribute to the clinical data of our country. Methods: Between January 2015 and July 2023, the patients’ test results of HBsAg, anti-HBs, anti-HBc, anti-HBc IgM, and HBV DNA requested from blood samples were retrospectively scanned along with demographic data of these patients. Results: Isolated anti-HBc positivity was observed in 1941 (6.0%) patients. Hepatitis B virus DNA positivity was 8.4% and anti-HBc IgM positivity was 0.6% in patients with isolated anti-HBc positivity. In addition, isolated anti-HBc positivity increased by age, was more common in males, and in internal medicine units (gastroenterology, oncology, general internal medicine, etc.). Conclusions: Consequently, anti-HBc IgM and/or HBV DNA positivity within an isolated anti-HBc positive pattern shows the infectivity of the disease. For this reason, in the diagnosis of HBV, in addition to HBsAg and anti-HBs, anti-HBc also needs to be tested, and anti-HBc IgM and HBV DNA need to be checked in every patient with isolated anti-HBc positivity.