Hepatitis B core-related antigen to detect hepatitis B virus (HBV) reactivation in heart transplant recipients with past HBV infection: A pilot study

Hepatitis B core-related antigen (HBcrAg) has been proposed as a new marker of hepatitis B virus (HBV) replication. We analyzed HBcrAg dynamics in 15 heart transplant recipients with active or prior HBV infection and correlated it with quantitative (QT)-HBsAg and HBV-DNA pre- and post-transplant. Serum HBcrAg was detected in HBsAg/HBV-DNA-positive subjects but not in recipients with past HBV infection. HBcrAg levels correlated with QT-HBsAg in pre- and post-transplant samples. In prior HBV infection, HBcrAg levels were unrelated to HBV-DNA positivity. In heart transplant recipients with prior HBV infection, HBcrAg does not correlate with viral replication and cannot be applied to detect HBV reactivation during follow-up.