From the Guidelines
A positive Hepatitis B core antibody (anti-HBc) test indicates that you have been infected with the Hepatitis B virus at some point in your life, and further testing is necessary to determine your current infection status. This finding requires additional blood tests, including Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (anti-HBs), to clarify whether you have an active infection, have recovered from a past infection with immunity, or have an occult (hidden) infection 1.
Interpretation of Test Results
The interpretation of these test results is crucial in determining the next steps in management. If HBsAg is positive, you have a current infection and should see a healthcare provider for monitoring and possible treatment with antiviral medications like entecavir or tenofovir 1. If anti-HBs is also positive, you likely have immunity from a resolved infection. If both additional markers are negative, you might have an occult infection or a false positive result.
Importance of Follow-up Testing
This testing is important because Hepatitis B can cause liver inflammation and potentially lead to cirrhosis or liver cancer if chronically active. Don't delay follow-up testing, as proper diagnosis ensures appropriate management of your liver health. According to the most recent guidelines, patients with evidence of HBV infection, including those with a positive anti-HBc test, should be monitored closely during anticancer therapy to prevent reactivation of the virus 1.
Management and Prevention
In certain cases, antiviral prophylaxis may be necessary to prevent reactivation of the virus, especially in patients undergoing systemic anticancer therapy or immunosuppressive therapy 1. It is essential to consult an HBV specialist for co-management, if available, to determine the best course of treatment and monitoring. The presence of anti-HBs can attenuate the risk of reactivation in patients with past HBV infection, but careful monitoring is still necessary to ensure early detection of any potential reactivation 1.
Key Points to Consider
- A positive anti-HBc test indicates past or current infection with Hepatitis B virus.
- Further testing, including HBsAg and anti-HBs, is necessary to determine current infection status.
- Monitoring and possible treatment with antiviral medications may be necessary for patients with current infection.
- Patients with past HBV infection should be monitored closely during anticancer therapy to prevent reactivation of the virus.
- Consultation with an HBV specialist is recommended for co-management and determination of the best course of treatment and monitoring.
From the Research
Hepatitis B Core Antibody Result Indication
A positive Hepatitis B (Hep B) core antibody (ab) result can indicate several things, including:
- Past or current infection with Hepatitis B virus (HBV) 2, 3, 4, 5, 6
- Immune response to HBV infection 2, 3, 4, 6
- Potential for HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B 2, 4
- Association with HBsAg clearance in HBeAg-negative patients with chronic hepatitis B 3, 6
- Possible false-positive result, especially in blood donors 5
Predictive Value of Hepatitis B Core Antibody
The level of hepatitis B core antibody has been shown to be a predictor of:
- HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B 2, 4
- HBsAg clearance in HBeAg-negative patients with chronic hepatitis B 3, 6
- HBV DNA undetectability and HBsAg seroclearance in HBeAg-seronegative patients 6
- Response to antiviral treatment in patients with chronic hepatitis B 2, 3, 4
Interpretation of Hepatitis B Core Antibody Results
The interpretation of hepatitis B core antibody results should take into account: