Research Article

IgM antibody against hepatitis B core antigen (IgM anti-HBc): diagnostic and prognostic significance in acute HBsAg positive hepatitis.

Br Med J (Clin Res Ed) 1983; 287 doi: https://doi.org/10.1136/bmj.287.6401.1254 (Published 29 October 1983) Cite this as: Br Med J (Clin Res Ed) 1983;287:1254
  1. C Lavarini,
  2. P Farci,
  3. E Chiaberge,
  4. V Veglio,
  5. D Giacobbi,
  6. G Bedarida,
  7. G Susani,
  8. M Toti,
  9. P Almi,
  10. N Caporaso

    Abstract

    IgM antibody against hepatitis B core antigen (IgM anti-HBc), a marker of recent hepatitis B virus infection, was sought by radioimmunoassay in sera diluted 1/4000 from 376 patients presenting to four centres in Italy with acute, apparently type B hepatitis (hepatitis B surface antigen (HBsAg) positive). In 320 patients (85%) a positive IgM anti-HBc test result confirmed that hepatitis was due to primary infection with hepatitis B virus. In the remaining 56 patients absence of the IgM marker indicated that they were previously unrecognised long term carriers of HBsAg. Further serum analysis often showed delta infection and occasionally hepatitis A or cytomegalovirus infection as the true cause of their illness. After six to eight months circulating HBsAg persisted in 38 of 45 patients (84%) without IgM anti-HBc but in only six of 150 patients (4%) with the IgM antibody (p less than 0.0001). A negative IgM anti-HBc test result in patients with acute HBsAg positive hepatitis points to a factor other than hepatitis B virus as the cause of the liver damage and predicts the carriage of HBsAg.