Presence of hepatitis B surface antibody in addition to hepatitis B core antibody confers protection against hepatitis B virus infection in hepatitis B surface antigen–negative patients undergoing kidney transplantation

Background The American Gastroenterological Association (AGA) and European Association for the Study of the Liver (EASL) recommend that hepatitis B surface antigen (HBsAg)-negative and hepatitis B core antibody (anti-HBc)-positive patients who receive immunosuppression should be monitored for hepatitis B virus (HBV) infection regardless of hepatitis B surface antibody (anti-HBs) status. However, anti-HBs may provide protection against infection. To investigate whether the presence of anti-HBs in addition to anti-HBc confers protection, we classified HBsAg(-) kidney transplantation (KT) patients into 4 groups according to anti-HBc and anti-HBs status, and compared the HBV infection rate between the anti-HBc(+)anti-HBs(+) group and the other 3 groups. Methods In this single-center retrospective study, we classified 1,959 patients into 4 groups: anti-HBc(-)anti-HBs(-) (n=356), anti-HBc(-)anti-HBs(+) (n=652), anti-HBc(+)anti-HBs(-) (n=142), and anti-HBc(+)anti-HBs(+) (n=809). Results HBV infection was noted in 31 patients (1.6%) after KT. There was a significant difference in HBV infection rate between anti-HBc(+)anti-HBs(+) (1.2%) and anti-HBc(+)anti-HBs(-) (5.6%) (p

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