Estimated Prevalence and Number of Persons With Isolated Antibody to Hepatitis B Core Antigen and Associated Occult Hepatitis B, United States, 2001-2018

Persons with isolated antibody to hepatits B virus (HBV) core antigen (IAHBc) may have occult HBV infection (OBI), which is associated with reactivation and potential risk for hepatocellular carcinoma and HBV transmission. We used National Health and Nutrition Examination Survey data to estimate US IAHBc prevalence and published studies of IAHBc-associated OBI prevalence to estimate OBI burden. During 2001-2018, the prevalence of IAHBc was 0.8% (approximately 2.1 million persons), and the OBI burden range was 35 500-83 600 persons. These data support the need for more robust estimates of IAHBc-associated OBI prevalence in the general US population. During 2001-2018, the prevalence of isolated antibody to hepatitis B virus (HBV) core antigen in the noninstitutionalized US population was 0.8% (approximately 2.1 million persons); the estimated burden of occult HBV infections ranged from 35 500 to 83 600 persons.