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

J Med Virol. 1992 Jan;36(1):16-20. doi: 10.1002/jmv.1890360104.


Because of widely differing reports on the significance of IgM anti-HBc in chronic hepatitis B virus (HBV) infection, paired sera and liver biopsies from 49 patients with chronic HBV infection were analysed for serum IgM anti-HBc, HBsAg titre, HBeAg/anti-HBe, HBV DNA, serum aspartate transaminase, intrahepatic HBcAg expression, and liver histology. High levels of IgM anti-HBc, in the diagnostic range of acute hepatitis B (greater than 1.2), were detected in seven patients (14.3%) and a total of 34 patients (69.6%) had an index of more than 0.2. No correlation was found between IgM anti-HBc and the serum markers of active viral replication or HBsAg titre but it correlated significantly with intrahepatic expression of cytoplasmic HBcAg (r2 = 0.165, P = 0.002). IgM anti-HBc also correlated with active liver histology (P = 0.015) but there was a considerable overlap of the IgM anti-HBc index values between the various disease groups, indicating a poor specificity. Serial assessment of IgM anti-HBc in eight patients treated with interferon-alpha (four responders) showed an increase in IgM anti-HBc in three out of four patients corresponding to the e-seroconversion period followed by a drop in IgM anti-HBc levels. However, an increase in IgM anti-HBc was also seen in one non-responder, indicating that this feature is not unique to interferon-alpha responders. These data indicate that serum IgM anti-HBc cannot be used alone as a certain diagnostic measure of HBV replication nor in the prediction of liver histology.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Hepatitis B / diagnosis
  • Hepatitis B / drug therapy
  • Hepatitis B / immunology*
  • Hepatitis B Core Antigens / immunology*
  • Humans
  • Immunoglobulin M / immunology*
  • Interferon-alpha / pharmacology
  • Liver / microbiology
  • Male
  • Middle Aged
  • Virus Replication


  • Hepatitis B Core Antigens
  • Immunoglobulin M
  • Interferon-alpha