Significance of serum IgM anti‐HBc in chronic hepatitis B virus infection

Smith, Hather. M.; Lau, Johnson Y. N.; Davies, Susan; Daniels, Helena M.; Alexander, Graeme; Williams, Roger

doi:10.1002/jmv.1890360104

Cited by 38 publications

(18 citation statements)

References 16 publications

(12 reference statements)

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“…The loss of HBeAg in chronic HBV carriers generally represents a late phase in the course of chronic HBV infection (89). Low levels of anti-HBc IgM are frequently detected in patients with chronic HBV infection, albeit without any diagnostic significance (244). Estimation of HBV DNA levels is one of the most useful markers in the management of chronic hepatitis B. Estimation of HBV DNA and ALT levels in serum, the presence of HBeAg, and the assessment of liver histology help in the evaluation and identification of patients requiring antiviral treatment for chronic hepatitis B (268).…”

Section: Diagnosismentioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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SUMMARY Chronic hepatitis B virus (HBV) infection is a complex clinical entity frequently associated with cirrhosis and hepatocellular carcinoma (HCC). The persistence of HBV genomes in the absence of detectable surface antigenemia is termed occult HBV infection. Mutations in the surface gene rendering HBsAg undetectable by commercial assays and inhibition of HBV by suppression of viral replication and viral proteins represent two fundamentally different mechanisms that lead to occult HBV infections. The molecular mechanisms underlying occult HBV infections, including recently identified mechanisms associated with the suppression of HBV replication and inhibition of HBV proteins, are reviewed in detail. The availability of highly sensitive molecular methods has led to increased detection of occult HBV infections in various clinical settings. The clinical relevance of occult HBV infection and the utility of appropriate diagnostic methods to detect occult HBV infection are discussed. The need for specific guidelines on the diagnosis and management of occult HBV infection is being increasingly recognized; the aspects of mechanistic studies that warrant further investigation are discussed in the final section.

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Section: Diagnosismentioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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“…In chronic infections, such as chronic hepatitis B (HB), it has been demonstrated that IgM antibodies to the nucleocapsid of HBV (anti-HBc) persist in circulation [Banninger et al, 1983;Chau et al, 1983;Cappel et al, 1981;Gerlich et al, 1980;Kiyosawa et al, 1986;Lemon et al, 1981;Roggendorf et al, 1981;Sjogren and Hoofnagle, 1985;Smith et al, 1992;Surrenti et al, 1986;Tedder and Wilson-Croome, 19811, and this persistence correlated with viral replication [Banninger et al, 1983;Kiyosawa et al, 1986;Sjogren and Hoofnagle, 1985;Roggendorf et al, 19811, the biological activity of chronic hepatitis B [Feinman et al, 19821 and a more aggressive state of the disease [Cappel et al, 19811. The IgM antibody has a similar prognostic value in chronic hepatitis delta virus (HDV) infection [Rizzetto, 1983;Smedile et al, 19821, where is has been found that the presence of IgM anti-HD correlated with underlying liver inflammation and was predictive of cirrhosis [Buti et al, 1987;Farci et al, 19861.…”

Section: Introductionmentioning

confidence: 99%

Immunoglobulin M reactivity towards the inununologically active region sp75 of the core protein of hepatitis C virus (HCV) in chronic HCV infection

Hellström

Sylvan

Decker

et al. 1993

Journal of Medical Virology

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Serum samples from a cohort of patients with chronic hepatitis C virus (HCV) infection were assayed for IgM anti-HCV/core reactivity with a "site-specific" ELISA, in which the solid phase was charged with the synthetic polypeptide analogue corresponding to the first 75 amino acids of the HCV core antigen (sp75). Thirteen of 24 (54%) patients exhibited IgM anti-sp75 reactivity. Both high-titered (1/16,000-1/32,000) and low-titered (1/1,000-1/4,000) IgM anti-sp75 reactive sera were found. IgM anti-sp75 antibodies persisted in the circulation over a long period in patients with fluctuating abnormal ALT levels. There was a striking association between detection of specific IgM anti-sp75 reactivity and the presence of HCV RNA in serum. Thus 11 of 15 (73%) sera containing HCV RNA also contained IgM anti-sp75 antibodies, while none of the HCV RNA-negative sera were IgM anti-sp75 reactive. Five of 11 patients without detectable levels of specific IgM anti-sp75 antibodies had their ALT levels returned to normal within 8 months to 3 years. Furthermore, a significant correlation was noted between the specific IgM anti-sp75 titers and the concentration of total plasma IgM, indicating that the immunological active region sp75 within the capsid of HCV has the capacity to induce an IgM secretion, which constitutes a substantial portion of the total plasma IgM, in patients with chronic HCV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…[9][10][11] However, IgM anti-HBc may become detectable during acute flare of chronic hepatitis B. 12,13 The index value of IgM anti-HBc would be a useful serologic marker to differentiate acute hepatitis B (AHB) from acute flare of chronic hepatitis B (CHB). 10,11,[14][15][16][17] Higher index values of IgM anti-HBc were found in AHB, while lower index values were detected in CHB.…”

Section: Introductionmentioning

confidence: 99%