Role of IgM antibody to hepatitis B core antigen in the diagnosis of hepatitis B exacerbations
IgM anti-HBc levels were measured by the IMx Core-M Abbott assay in 939 serum samples in order to define a specific and sensitive cut-off value for diagnosis of chronic hepatitis B. The sera used were obtained from 52 chronic HBV patients and 10 HBV carriers with HCV or HDV co-infections and 155 asymptomatic subjects without evidence of liver disease. A Youden index value of 95.4% with 98% sensitivity and 97.4% specificity was obtained for an IMx Index value of 0.204 as cut-off. A one-year follow-up study with monthly tests has shown that quantitative analysis of IgM anti-HBc can serve as a non-invasive tool for monitoring HBV infection, and provides an accurate diagnosis of hepatitis B exacerbations. Significant elevations of IgM anti-HBc levels were associated with hepatitis B excerbations in 96.2% of the cases but with none of the ALT flare-ups observed in HCV or HDV infected individuals. These results suggest that quantitative analysis of IgM anti-HBc provides the highest degree of confidence in definition of spontaneous and therapy-induced exacerbations or remissions of hepatitis B.
KeywordsChronic Hepatitis Core Antigen Chronic Type Chronic Persistent Hepatitis Chronic HBsAg Carrier
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- 1.Brunetto MR, Arrigoni A, Toti M, Almi P, Zanetti A, Ferroni P, Doris R, Aneloni V, Crovari P, Coppola RC, Bonino F (1988) The diagnostic significance of IgM antibody to B core antigen, revisited. Ital J Gastroenterol 20: 167–170Google Scholar
- 2.Brunetto MR, Torrani Cerentia M, Olivieri F, Piantino P, Randone A, Calvo PL, Bonino F (1993) Monitoring the natural course and response to therapy of chronic hepatitis B with an automated semi-quantitative assay for IgM anti-HBc. J Hepatol (in press)Google Scholar
- 4.Colloredo Mels G, Bellati G, Leandro G, Brunetto MR, Vicari O, Borzio M, Piantino P, Fornaciari G, Scudeller G, Angeli G, Bonino F, Ideo G (1993) Fluctuations of viremia, aminotransferases and IgM antibody to hepatitis B core antigen in chronic hepatitis B patients with disease exacerbations. Liver (in press)Google Scholar
- 10.Feinstein AR (1985) Clinical epidemiology: the architecture of clinical research. W.B. Saunders, Philadelphia, pp 434–437Google Scholar
- 12.Gerlich WH, Luer W, Thomssen R, The Study Group for Viral hepatitis of the Deutsche Forschungsgemeinschaft (1980) Diagnosis of acute and inapparent hepatitis B virus infection by measurement of IgM antibody to hepatitis B core antigen. J Infect Dis 142: 85–101Google Scholar
- 32.Sjogren M, Hoofnagle JH (1985) Immunoglobulin M antibody to hepatitis B core antigen in patients with chronic type B hepatitis. Gastroenterology 85: 252–258Google Scholar
- 34.Weinstein MC, Fineberg HV (1980) Clinical decision analysis. W.B. Saunders, Philadelphia, pp 601–609Google Scholar