B 형 급성간염에서 IgM Anti - HBc 의 진단적 의의 = The Diagnostic Significance of IgM anti - HBc in Acute Hepatitis B

다국어 초록 (Multilingual Abstract)

To investigate the diagnostic significance of IgM anti-HBc in acute hepatitis B, IgM anti-HBc was measured by radioimmunoassay in 41 pateitns with acute hepatitis B, 18 patients with chronic hepatitis, 29 patients with liver cirrhosis, 1S patients with primary hepatoma, and 23 healthy carriers. The results obtained were as follows; 1) Distribution of Hepatitis B virus markers in acute hepatitis B Of the 41 patients with acute hepatitis B, 29 patients (70.8%) were seropositive for HBsAg and IgM anti-HBc, 6 patients (14.6%) were seropositive for HBsAg and seronegative for IgM anti-HBc, 5 patients (12.2%) were seronegative for HBsAg and serapositive for IgM anti-HBc, and 1 patient (2.4%) was seronegative for HBsAg and IgM anti-HBc. 2) IgM anti-HBc in acute hepatitis B Of the 41 patients with acute hepatitis B, 34 patients (82.9%) were IgM anti-HBc positive. IgM anti-HBc was tested in 33 patients with positive IgM anti-HBc within 2 weeks after onset of jaundice, and tested in 7 patients with negative IgM anti-HBc more than 4 weeks after onset of jaundice. IgM anti-HBc titer decreased gradually with time in 12 patients with positive IgM anti-HBc in whom the follow up evaluation was available. In 3 patients, IgM anti-HBc became negative seroconversion at 4 weeks after onset of jaundice, In 3 patients, IgM anti-HBc became negative seroconversion at 9 weeks, 11 weeks, and 20 weeks after onset of jaundice, respectively. IgM anti-HBc was more frequently detected in acute hepatitis B compared with chronic liver diseases (p<0.05) and 23 of 41 patients (56.1%) with acute hepatitis B had P/N ratio over 4. 3) IgM anti-HBc in chronic liver disease IgM anti-HBc was postitive in 2 of 1S patients (11.1%) with chronic hepatitis B, 5 of 29 patients (17.2%) with liver cirrhosis, 3 of 18 patients (~26.7%) with hepatoma, and 1 of 23 (4.3%) healthy carriers. Among these, only 2 patients (7%) with liver cirrhosis had P/N ratio over 4. 4) The relationship between HBeAg and IgM anti-HBc in acute hepatitis B There was no significant difference in positivity and P/N ratio of IgM anti-HBc between HBeAg positive and negative patients with acute hepatitis B(p<0.1), In conclusion, IgM anti-HBc testing can aid in the diagnosis of acute hepatitis 8. But if IgM anti-HBc testing is performed more than 4 weeks after onset of jaundice, it could be negative in acute hepatitis B. And it should be careful to diagnose acute hepatitis B because there is false negative results on conventional radioimmunoassay in acute hepatitis B.