Serodiagnosis of Recent Hepatitis B Infection by Igm Class Anti–Hbc

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Abstract
Time sequence, relative reactivity, and persistence of anti–HBc IgM were assessed in patients with HBsAg–positive viral hepatitis. A solid–phase immunoassay was developed using the IgM capture procedure with anti–m¨ated polystyrene beads. HBcAg was purified from serum Dane particles and used as a probe with 125I–labeled anti–HBc IgG. This immunoassay exhibited a pronounced prozoning phenomenon, and relative titers of sera differed widely depending upon the dilution of serum tested. When all sera were tested at 1:5,000 dilution, results were comparable in different patient groups. HBc IgM persisted at detectable levels for up to 2 years, and it was necessary to establish relative titers to discriminate current from remote infections. A cut–off assay value was established, and in 12 cases of acute hepatitis B virus (HBV) infection, antibody exceeded this value for about 6 months after onset of HBs antigenemia. A similar profile of anti–HBc IgM persistence was observed in seven patients who developed an HBsAg chronic carrier state. Long–term viral replication did not sustain elevated IgM class–specific antibody levels. studies suggest that anti–HBc IgM analyses may be useful for differentiating recent and current HBV infections from remote infections, eliminating HBV as the agent for non–A, non–B hepatitis in asymptomatic HBsAg carriers, and detecting HBV as the etiologic agent during silent (HBsAg negative) infections.