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.
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Gish et al. (2020) studied this question.
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