A case of HBs antigen negative fulminant hepatitis with IgM antibody to hepatitis B core antigen persisting more than seven years.
A 33-year old dentist developed fulminant hepatitis. At admission, a test for IgM antibody to hepatitis B core antigen (IgM anti-HBc) was positive, while tests for HBsAg and HBeAg were negative. He was cured of the disease, but in follow-up examinations from 1983 to 1990 IgM anti-HBc was continuously detected with radioimmunoassay while HBsAg and HBV-DNA were absent in the serum. However, HBcAg was found in a biopsied liver specimen and a small quantity of HBV-DNA was detectable by polymerase chain reaction assay. These observation suggest that the continuous detection of IgM anti-HBc without HBsAg in serum is due to persistent HBV infection and HBV replication in the liver.
Suga
M
M
Department of Internal Medicine (Section 1), Sapporo Medical College, Japan.
Shibata
K
K
Kodama
T
T
Arima
K
K
Yamada
S
S
Yachi
A
A
D000328:Adult; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000175:diagnosis* / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006521:Hepatitis, Chronic / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D008111:Liver Function Tests; D008297:Male
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D007075:Immunoglobulin M