Isolated anti-HBc positivity ups liver-related death risk

Isolated hepatitis B core antibody (anti-HBc) positivity appears to increase the risk of liver-related and liver cancer mortality, particularly when accompanied by a high fibrosis score, according to a study of Korean adults.

A total of 609,299 Korean adults who underwent hepatitis B serologic markers as part of a health examination were included in this cohort study. Using the National Death Records, the authors determined liver-related and liver cancer mortality.

There were 554 liver-related deaths recorded during a median follow-up of 9.0 years (liver-related mortality, 9.6 cases per 10⁵ person-years). Isolated anti-HBc positivity prevalence was 3.8 percent, equivalent to 23,399 participants, and was age-dependent.

Hazard ratios for liver-related mortality after adjustment for age, sex, and other confounders were 1.69 (95 percent confidence interval [CI], 1.22‒2.33) in isolated anti-HBc-positive participants and 27.02 (95 percent CI, 21.45‒34.04) in hepatitis B surface antigen‒positive adults compared with HBV-unexposed individuals. Such associations were evident in analyses using liver cancer death as an outcome.

The risks of liver-related and liver cancer mortality among isolated anti-HBc-positive patients were significantly greater in those with high fibrosis-4 scores than HBV-unexposed patients (adjusted HRs, 15, 95 percent CI, 9.21‒26.37 and 72.66, 95 percent CI, 36.96‒142.86, respectively).

“Isolated anti-HBc positivity may be an independent risk factor for liver-related outcomes, especially in high-endemic areas,” the authors said.