Immune Suppression as the Etiology of Failure To Detect Anti-HBc Antibodies in Patients with Chronic Hepatitis B Virus Infection

Abstract
A lack of anti-HBc antibodies during chronic hepatitis B virus infection is a serological pattern that is rarely observed. In our series of 39 patients with such a confirmed profile, mutations within the precore/core gene were rarely found and the lack of antibody detection was mostly explained by concurrent immunosuppression and the low sensitivities of the serological assays.