B 형 간염 에 있어서 IgM anti HBc 의 발현도 및 임상적 의의 = Prevalence and Significance of IgM AntiHBc in Viral Type B Hepatitis

다국어 초록 (Multilingual Abstract)

Testing for IgM antiHBc was useful to detecting the patients with negative and positive HBsAg viral hepatitis and may improve serodiagnostic accuracy when acute NANB and delta agent hepatitis occur in previousely unrecognized HBsAg carriers. Moreover, it may be a useful test in defining potentially high risk sources of exposure to hepatitis B virus. But it is not useful in distinguishing recent from remote infection because IgM antiHBc occasionally was found in chronic liver diseases, IgM antiHBc was found by ELISA in 32 patients with acute viral hepatitis B, 61 with chronic hepatitis B, 18 patients with liver cirrhosis, 36 healthy HBsAg carriers and l49 patients with positive antiHBc alone. We continuously evaluated HBsAg and liver function of the patients who had negative IgM antiHBc acute hepatitis. The results are summarized as follows: 1) IgM antiHBc was positive in 84.4% of acute hepatitis B, 4% of chronic hepatitis B, 5.5% of positive HBsAg liver cirrhosis, 2. 8% of HBsAg healthy carriers but was all negative in patients with positive antiHBc alone. 2) Three patients with negative HBsAg acute viral hepatitis was diagnosed by positive IgM antiHBc as acute viral hepatitis R. 3) During the follow-up of 5 patients with negative IgM antiHBc acute hepatitis, 2 patients were diagnosed as type B acute viral hepatitis because of disappearance of HBsAg and normalization of liver function. And another 3 patients were diagnosed as non-B acute viral hepatitis superimposed on HBsAg carrier or natural course of chronic hepatitis.