title: Significance of serum IgM anti-HBc in chronic hepatitis B virus infection.
abstract: Because of widely differing reports on the significance of IgM anti-HBc in chronic hepatitis B virus (HBV) infection, paired sera and liver biopsies from 49 patients with chronic HBV infection were analysed for serum IgM anti-HBc, HBsAg titre, HBeAg/anti-HBe, HBV DNA, serum aspartate transaminase, intrahepatic HBcAg expression, and liver histology. High levels of IgM anti-HBc, in the diagnostic range of acute hepatitis B (greater than 1.2), were detected in seven patients (14.3%) and a total of 34 patients (69.6%) had an index of more than 0.2. No correlation was found between IgM anti-HBc and the serum markers of active viral replication or HBsAg titre but it correlated significantly with intrahepatic expression of cytoplasmic HBcAg (r2 = 0.165, P = 0.002). IgM anti-HBc also correlated with active liver histology (P = 0.015) but there was a considerable overlap of the IgM anti-HBc index values between the various disease groups, indicating a poor specificity. Serial assessment of IgM anti-HBc in eight patients treated with interferon-alpha (four responders) showed an increase in IgM anti-HBc in three out of four patients corresponding to the e-seroconversion period followed by a drop in IgM anti-HBc levels. However, an increase in IgM anti-HBc was also seen in one non-responder, indicating that this feature is not unique to interferon-alpha responders. These data indicate that serum IgM anti-HBc cannot be used alone as a certain diagnostic measure of HBV replication nor in the prediction of liver histology.
authors.affiliation: Institute of Liver Studies, King's College School of Medicine and Dentistry, London, United Kingdom.
authors.forename: H M
authors.initials: HM
authors.lastname: Smith
authors.forename: J Y
authors.initials: JY
authors.lastname: Lau
authors.forename: S E
authors.initials: SE
authors.lastname: Davies
authors.forename: H M
authors.initials: HM
authors.lastname: Daniels
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology*; D016898:Interferon-alpha / Q000494:pharmacology; D008099:Liver / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D014779:Virus Replication
chemical_list: D006512:Hepatitis B Core Antigens; D007075:Immunoglobulin M; D016898:Interferon-alpha