IgM antibody against hepatitis B core antigen (IgM anti-HBc): diagnostic and prognostic significance in acute HBsAg positive hepatitis

IgM antibody against hepatitis B core antigen (IgM anti-HBc), a marker of recent hepatitis B virus infection, was sought by radioimmunoassay in sera diluted 1/4000 from 376 patients presenting to four centres in Italy with acute, apparently type B hepatitis (hepatitis B surface antigen (HBsAg) posit...

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Bibliographic Details
Published in:BMJ 1983-10, Vol.287 (6401), p.1254-1256
Main Authors: Lavarini, C, Farci, P, Chiaberge, E, Veglio, V, Giacobbi, D, Bedarida, G, Susani, G, Toti, M, Almi, P, Caporaso, N
Format: Article
Language:English
Subjects:
Acute Disease
Antibodies
Biological and medical sciences
Carrier State - diagnosis
Diseases
Drug carriers
Hepatitis
Hepatitis antigens
Hepatitis B
Hepatitis B - diagnosis
Hepatitis B - immunology
Hepatitis B Core Antigens - immunology
Hepatitis B Surface Antigens - analysis
Hepatitis B virus
Human viral diseases
Humans
Immunoglobulin M - analysis
Infections
Infectious diseases
Liver
Medical sciences
Prognosis
Radioimmunoassay
Viral diseases
Viral hepatitis
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Summary:IgM antibody against hepatitis B core antigen (IgM anti-HBc), a marker of recent hepatitis B virus infection, was sought by radioimmunoassay in sera diluted 1/4000 from 376 patients presenting to four centres in Italy with acute, apparently type B hepatitis (hepatitis B surface antigen (HBsAg) positive). In 320 patients (85%) a positive IgM anti-HBc test result confirmed that hepatitis was due to primary infection with hepatitis B virus. In the remaining 56 patients absence of the IgM marker indicated that they were previously unrecognised long term carriers of HBsAg. Further serum analysis often showed delta infection and occasionally hepatitis A or cytomegalovirus infection as the true cause of their illness. After six to eight months circulating HBsAg persisted in 38 of 45 patients (84%) without IgM anti-HBc but in only six of 150 patients (4%) with the IgM antibody (p less than 0.0001). A negative IgM anti-HBc test result in patients with acute HBsAg positive hepatitis points to a factor other than hepatitis B virus as the cause of the liver damage and predicts the carriage of HBsAg.
ISSN:0007-1447
0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.287.6401.1254