significance of hepatitis b core antibody as the only marker of hepatitis b virus infection in high risk patients

background and objective: presence of hepatitis b core antibody (anti-hbc) in the absence of hepatitis b surface antigen (hbsag) and hepatitis b surface antibody (anti-hbs) is defined, as isolated anti-hbc. little is known about the clinical significance of the isolated anti-hbc in hepatitis b virus (hbv) infections. the aim of this study was to assess the significance of anti-hbc as the only marker of hbv infection in high risk patients. patients and methods: in this cross-sectional study, 395 patients including 289 patients on chronic hemodialysis (hd) and 106 hiv infected subjects were enrolled. hbsag, anti-hbs, anti-hbc, hepatitis c antibody (anti-hcv) and alanine aminotransferase (alt) levels were tested in all subjects. the presence of hbv-dna was determined quantitatively in plasma samples of patients with isolated anti-hbc by real-time pcr. results: of 395 patients, 40 (10.13%, 95% ci, 7.1%-13.1%) had isolated anti-hbc. hbv-dna was detectable in 12 of 40 patients (30%, 95% ci, 15.8%-44.2%) who had isolated anti-hbc. conclusion: our study showed that detection of isolated anti-hbc could reflect unrecognized hbv infection; hence, screening of these patients is useful to preventing of hbv transmission.