Significance of serum immunoglobulin M to hepatitis C virus core in patients with chronic hepatitis C.
OBJECTIVE
Anti-hepatitis C virus (HCV) IgM antibodies were found in patients with both acute and chronic hepatitis C. The aims of this study were to determine the significance, in terms of liver disease, virological parameters, and response to interferon therapy, of IgM antibody to hepatitis C virus core protein (IgM anti-HCV-core) in the serum of patients with chronic hepatitis C.


METHODS
The presence of IgM anti-HCVcore was investigated in 42 patients with chronic hepatitis C. Tests for IgM anti-HCVcore was carried out before interferon therapy. The patients received 3 MU of interferon-alpha three times weekly for 6 months. A response to interferon therapy was defined as normal transaminase activity and negative viremia at the end of treatment (month 6: response), and a sustained response was defined as normal ALT values and negative viremia for 6 months after completion of therapy.


RESULTS
Sixteen patients (38%) displayed IgM anti-HCVcore. The mean Knodell score of the IgM anti-HCVcore-positive patients was significantly higher than that of the IgM anti-HCVcore-negative patients (11.5 +/- 3.4 vs. 9.1 +/- 3.1, p = 0.04), and the occurrence of IgM anti-HCVcore tended to be associated with serotype 1 virus (p = 0.08). Finally, a significantly higher percentage of responders to interferon at the end of therapy were IgM anti-HCVcore negative (p = 0.04), and only one patient with a ratio of sample to cutoff over 2.0 responded to interferon.


CONCLUSIONS
IgM anti-HCVcore appears to be a simple serological marker of more severe liver disease in patients with chronic hepatitis C and may have relevance to the outcome of antiviral therapy.
Tran
A
A
Department of Immunology, Archet Hospital 2, Nice, France.
Yang
G
G
Dreyfus
G
G
Rouquié
P
P
Durant
J
J
Rampal
A
A
Rampal
P
P
Benzaken
S
S
D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D018937:Hepatitis C Antibodies / Q000097:blood*; D018936:Hepatitis C Antigens / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000276:immunology* / Q000628:therapy / Q000821:virology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D014758:Viral Core Proteins / Q000276:immunology*
D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D007075:Immunoglobulin M; D016898:Interferon-alpha; D012367:RNA, Viral; D014758:Viral Core Proteins; C069130:nucleocapsid protein, Hepatitis C virus