“Antihbc(+) Only” as a Marker of Hepatitis B Virus Infection in Drug Users Under Substitution Treatment in Greece

Author: Olga Anagnostou Katerina Micha Efrosyni Tsirogianni Eleftheria Petroulaki Katerina Kaliva Ioanna Detsi Maria Kollitsida Giorgos Androulakis Melpomeni Gargoulaki Vassilios Karagounis Anna Katsili Stavroula Kollia Melpomeni Argiris Kotsalis Konstantinos Stamatopoulos Victoria Stavridou Christos Tanis Panagiota Tsekoura Yolanda Topalidou - Stepin Anastasios Tsantilas Emmanuel Chalkiadakis Anastasia Drimousi Athanasios Theoharis

Theme: Epidemiology & Public Health Research Year: 2022

“AntiHbc(+) only” as a biomarker of HBV exposure needs proper attention due to the
potential risk of HBV reactivation. Our aim was to study the prevalence of antiHBc(+) alone
in PWID under OST in Greece and its possible correlations with other patient characteristics.
A retrospective analysis of OKANA data collected on May 2021 from individuals with
available results for HBsAg, AntiHBs, AntiHBc, AntiHCV and AntiHIV was conducted. In total
5,431 patients[85.7% men, mean age 48.5±9.1 years and 14.3% women mean age 47.6±9.3
years, 71% buprenorphine, 67.9% AntiHCV(+) and 5.3% antiHIV(+)] were analyzed,
representing 68.7% of the 7,903 OST patients in Greece on May 2021.
HBsAg(+) was detected in 2.8% while 32.3% were naturally immune [HBsAg(-
)/antiHBc(+)/antiHBs(+)]. History of vaccination was confirmed in 22.2% but 44.8% were still
susceptible. Previous HBV exposure [HBsAg(+)/antiHBc(+)/antiHBs(+)] was evident in
1754/5431 (32.3%) in total.
“AntiHBc(+) only” was recorded in 608 individuals(11.2%), with the lowest rate found in
antiHCV(-) [3.6% vs 14.8% for antiHCV(+) (p <0.0001)] and the highest in antiHIV(+) [25.2% vs
10.4 % in antiHIV(-), (p <0.0001)] individuals.
The ratio of AntiHBc(+) alone among those with evidence of HBV exposure was 34.7%
(608/1754) and was increasing with antHCV(+) (35.8% vs 27.1%, p=0.01), antiHIV(+) (42.4%
vs 33.8%, p=0.024) and at Athens OST units (37,1 vs 30,2% for rest Greece, p=0.01). After
regression analysis only antiHCV(+) (OR 1.44, 95% CI:1.05-1.97, p=0.022) and Athens location
(OR 1.34, 95%CI: 1.08-1.65, p=0.008) remained significant for increased AntiHBc(+) ratio.
A significant proportion of PWID at OST programs in Greece present antiHBc(+) as the only
HBV marker. HCV infection significantly increases this likelihood. It is crucial to identify
“antiHBc(+) only” drug users with CHC before DAAs initiation, in order to monitor for ALT
flares during treatment and prevent any HBV reactivation.
Disclosure of Interest Statement:
Nothing to disclose.

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