Diagnosis of hepatitis C virus related acute hepatitis by serial determination of IgM anti-HCV titres

• Published in: Journal of hepatology Vol. 42; no. 5; pp. 646 - 651
• Main Authors: Sagnelli, Evangelista, Coppola, Nicola, Marrocco, Cecilia, Coviello, Giancarlo, Battaglia, Martina, Messina, Vincenzo, Rossi, Giovanni, Sagnelli, Caterina, Scolastico, Carlo, Filippini, Pietro
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.05.2005; Elsevier
• Subjects: Acute Disease; Acute Hepatitis C; Adult; Alpha-Interferon; Biological and medical sciences; Early Diagnosis; Female; Hepatitis C - diagnosis; Hepatitis C - immunology; Hepatitis C - virology; Hepatitis C Antibodies - blood; Human viral diseases; Humans; IgM anti-HCV titres; Immunoglobulin M - blood; Infectious diseases; Male; Medical sciences; Middle Aged; Recurrence; Viral diseases; Viral diseases of the digestive system; Viral hepatitis; Viral Load; IgM anti-HCV titres; Alpha-Interferon; Acute Hepatitis C; Alpha interferon; Acute; Hepatic disease; IgM; Infection; Virus; Viral disease; Digestive diseases; Diagnosis; Flaviviridae; Hepatitis C virus; Hepacivirus; Viral hepatitis C
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2004.12.027

We investigated whether serial determination of IgM to HCV core protein (HCV IgM) may be useful to identify acute hepatitis C (AHC) and to distinguish this disease from reactivation of chronic hepatitis C (r-CHC). We enrolled 35 consecutive patients with AHC identified by seroconversion to anti-HCV and 31 consecutive patients who had been anti-HCV positive for at least six months at the time of reactivation. Titres of HCV IgM were calculated as Index values by a commercially available enzyme immunoassay. During the early phase of the illness we observed a wide variation in the HCV IgM Index values in all patients in the AHC group and consistent values in all cases in the r-CHC group. The HCV viral load determined soon after the onset of symptoms was of no use in identifying AHC.Twenty-three patients in the AHC group were observed as outpatients for 6-30 months; of these, 10 became plasma HCV-RNA negative within the third month of observation, but three showed a subsequent reactivation of HCV infection. Our data indicate that the detection of high and variable titres of HCV IgM in the early phase of the illness may identify acute hepatitis C and allow early antiviral treatment.