Neopterin and soluble CD14 (sCD14) levels as immunoactivation markers in aHBc-only cases

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Neopterin serves as a marker of cellular immune system activation and soluble CD14 is also a marker of monocyte activation. Utilizing only these markers with low sensitivity but high specificity is not possible to decide whether an individual has an occult HBV infection (OBI) or aHBc-alone. We tried to give an alternative perspective to understand the complex and unpredictable nature of aHBc-alone cases by evaluating the immunostatus of these cases. However, the accurate detection of one of the OBI patients with high HBV DNA viral load (274,000 IU/ ml) is promising even though we were not to be able to detect other OBI cases with low HBV DNA viral load (204 IU/ml). The limitation of our work was finding only two cases with OBI or aHBc-alone; however, this is the first study investigating cases with OBI and aHBc-alone by using neopterin and sCD14 biomarkers. Both markers can shed a light on the immune status of aHBc-alone, specifically OBI cases. We tried to give an insight to the complex and troublesome nature of the immune status in cases with aHBc-alone in developing countries such as Turkey which have usually resource-constrained settings therefore avoid costly expensive molecular diagnostic tests. We also tried to present a reference related to the neopterin and sCD14 association in the cases with aHBc-alone in this very limited study.

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