IgM anti-hepatitis C virus in patients with chronic non-A, non-B hepatitis and their relationship to viral replication.
Patients with hepatitis C virus (HCV) infection may have different patterns of antibody response to various structural and non-structural viral antigens. We have correlated the serological patterns to the clinical features of chronic infection and to viral replication in 68 HCV-Ab-positive patients with chronic liver disease at different stages (19 with cirrhosis-hepatocellular carcinoma, 38 with chronic active hepatitis and 11 with chronic persistent hepatitis). Serum samples from each patient were assayed for HCV-IgM by enzyme immunoassay and for HCV-RNA by the polymerase chain reaction using primer sets derived from the 5'-non-coding region. The prevalence of HCV-IgM was high (54 patients (79.4%)) and the study showed a good correlation between high values of anti-HCV-IgM and the presence of HCV-RNA in serum, since HCV-RNA was detected in 35 of the 54 IgM-positive patients (64.8%) and notably in 19 of the 20 subjects with high levels of specific IgM. Conversely, all the 35 sera containing HCV-RNA were also reactive for HCV-IgM, while none of the HCV-IgM-negative sera was HCV-RNA reactive. Positivity rates for both HCV-RNA and IgM anti-HCV were higher in the more advanced stages of disease; thus, the clinical pattern of HCV chronic hepatitis seems to be strictly related to the serological pattern and the presence of HCV-RNA.
Mancini
C
C
Institute of Microbiology, Faculty of Medicine, University La Sapienza, P. le A. Moro 5, 00185 Rome, Italy.
Rivanera
D
D
Lilli
D
D
Di Cuonzo
G
G
Angeletti
S
S
Lorino
G
G
De Sanctis
G M
GM
Barbacini
I G
IG
Leonetti
G
G
Bianchi
P
P
Chircu
L V
LV
Galli
C
C