Anti-HBcore (суммарные антитела к ядерному антигену вируса гепатита В)

The Hepatitis B core antibody (anti-HBc), total test (also known as HBcAb, total or HBV core total antibody [IgG + IgM]) assesses exposure to hepatitis B virus across the disease spectrum. It aids detection of HBV infection even when other hepatitis markers are absent, supports the differential diagnosis of viral hepatitis, documents prior HBV infection, and, together with other HBV-specific markers, helps determine disease phase (acute, chronic, or past infection).

Hepatitis B virus (HBV) is a DNA virus that causes liver disease and remains highly prevalent worldwide. Many infections are asymptomatic and first recognized during preventive screening. Approximately 350 million people are affected globally, and 620 thousand deaths occur each year due to HBV-related complications. Infection sources include individuals with active disease and carriers. Transmission occurs through blood and other body fluids, including sexual exposure, reuse of nonsterile needles or syringes, blood transfusion, organ transplantation, and perinatal spread from mother to child during or after delivery (for example, via nipple fissures). Populations at increased risk include healthcare personnel with blood exposure, hemodialysis patients, people who inject drugs, individuals with multiple unprotected sexual partners, and infants born to mothers with HBV infection. The incubation period ranges from 4 weeks to 6 months. Clinical presentations vary from short, mild illness lasting several weeks to chronic infection that can persist for years. Symptoms frequently include jaundice, fever, nausea, and fatigue, while laboratory testing shows biochemical evidence of hepatic injury along with HBV-specific antigens. Outcomes of acute infection include fulminant disease with potential fatality, progression to chronic infection, or complete recovery. Durable immunity typically develops after recovery from HBV. Chronic HBV infection is associated with cirrhosis and hepatocellular carcinoma. Serologic evaluation relies on viral antigens and corresponding antibodies. Key antigens for laboratory practice are HBsAg (surface), HBcAg, and HBeAg (core-associated). HBcAg is highly immunogenic, yet it is not detected in blood because it resides within hepatocytes. Antibodies to the core antigen (anti-HBc) appear early—about 3–5 weeks after exposure—and often become positive near the end of the prodrome in immunocompetent individuals. Anti-HBc IgM arises first in response to active viral replication and wanes during convalescence; anti-HBc IgG appears by months 4–6 and may persist for years or lifelong. Total anti-HBc confirms prior exposure to HBV even when other hepatitis B markers are negative. Determining the phase of infection (acute, chronic, or resolved) requires interpretation of individual antibody classes together with other HBV antigens and markers.