Original paper: PDF OnlyHepatitis B virus reactivation or reinfection associated with HIV-1 infectionWaite, James; Gilson, Richard J.C.*; Weller, Ian V.D.*; Lacey, Charles J.N.†; Hambling, Milton H.‡; Hawkins, Anna*; Briggs, Moya; Tedder, Richard S. Author Information From the Section of Virology, Department of Medical Microbiology, *Academic Department of Genito-Urinary Medicine, University College and Middlesex School of Medicine, London, †Department of Genito-Urinary Medicine, The General Infirmary at Leeds and the, ‡Virology Department, Public Health Laboratory Service, Leeds, UK. AIDS: December 1988 - Volume 2 - Issue 6 - p 443-448 Buy Abstract Following acute hepatitis B virus (HBV) infection, most individuals develop antibodies to HBV surface (anti-HBs) and core antigen (anti-HBc). Prevalence studies have shown that 10–18% develop anti-HBc in the absence of detectable anti-HBs. We report four such cases, all with persistence of serum anti-HBc, who had evidence of a second period of active HBV replication as demonstrated by the reappearance of serum hepatitis B surface antigen (HBsAg). In one patient, an HBsAg subtype difference indicated that the second period of HBsAg-positivity was due to a reinfection. In the other cases, reactivation may also explain the findings. All cases were anti-HIV-1 seropositive at the time of reappearance of HBsAg. There is experimental evidence that anti-HBc has a protective effect against HBV infection; however, this may require intact cell-mediated immunity to be effective. HIV-1 infection may render such patients susceptible to reinfection. Alternatively, some patients with anti-HBc, but without detectable anti-HBs may have latent HBV infection. Immunosuppression associated with HIV-1 infection may allow reactivation. © Lippincott-Raven Publishers.