Quantitative assessment of serum IgM anti-HBc in the natural course and during interferon treatment of chronic hepatitis B virus infection

✍ Scribed by George Marinos; Heather M. Smith; Nikolai V. Naoumov; Roger Williams

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 740 KB
• Volume: 19
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840190207

✦ Synopsis

Serum IgM anti-HBc was determined in 135 chronic HBsAg carriers with various categories of histological activity on liver biopsy and hepatitis B serological profile. Thirty-three patients were treated with interferon-a to investigate the correlation between serum IgM anti-HBc with histological activity and viral replication, to evaluate the usefulness of pretreatment IgM anti-HBc as a predictor of a successful response to interferon-a and to examine the IgM anti-HBc response during this treatment. All 53 patients with chronic active hepatitis with either wild-type (n = 42) or precore mutant variant HBV infection (n = 11) had an I g M anti-HBc index greater than 0.300 compared with 7.4% (2 of 27) of the chronic HBsAg/HESeAg-positive carriers with chronic persistent hepatitis, 10% (3 of 30) of the anti-HBe-positive asymptomatic carriers and none of the 25 patients with hepatitis D virus-positive chronic active hepatitis (p i 0.0001). Pretreatment IgM anti-HBc index was greater than 0.300 in 82.4% (14 of 17) of HBeAg/HBV DNA-positive patients who seroconverted after interferon-a treatment compared with 25% (4 of 16) of the patients who did not seroconvert (p = 0.0013), whereas an elevated pretreatment AST was present in only 52.9% (9 of 17) of responders and in 37.5% (6 of 16) of nonresponders (p = 0.42). Serial testing of IgM anti-HBc in these 33 patients during interferona treatment showed a significant rise in IglM anti-HBc in all responders, which followed the AST flare-up but preceded the time of the HBeAg to anti-HBe seroconversion. The data presented indicate that serum IgM anti-HBc is a good surrogate marker for hepatocellular damage immunopathologicdy related to hepatitis B virus and is a better predictor of a beneficial response to interferon-a treatment than serum AST. IgM anti-HBc indicates the induction of the immune response to HBcAg during the course of chronic HBV infection but is not directly involved in the elimination of the infected hepatocytes. (HEPA-