Perceived significance of isolated HBcAb in patients with HIV: A survey of practitioners

The prevalence of the isolated hepatitis B core Ab phenotype ( hepatitis B surface antigen negative [ HBsAg-] hepatitis B surface antibody negative [ HBsAb-], and hepatitis B core antibody positive [ HBcAb-] is particularly high among human HIV- positive patients. Controversy exists regarding both the significance of this phenotype and the risk of progressive liver disease as well as the need for hepatitis B vaccination in this population. A survey of 40 HIV primary care providers ( PCPs) at an urban outpatient HIV clinic was conducted in 2005 regarding these two issues and a summary of the findings are presented in this report. Seventyeight percent thought that these patients' infection had resolved and were immune, half thought they were at risk for progressive liver disease, and 6 ( 15%) routinely administered hepatitis B vaccine to patients with this phenotype. The wide variety in attitudes and practices among providers in a single clinic suggests the need for further research and development of management guidelines in this group of patients.