SIGNIFICANCE OF SERUM IMMUNOGLOBULIN-M TO HEPATITIS-C VIRUS CORE IN PATIENTS WITH CHRONIC HEPATITIS-C

Objectives: Anti-hepatitis C virus (HCV) IgM antibodies were found in patients with both acute and chronic hepatitis C. The aims of this stu dy were to determine the significance, in terms of liver disease, viro logical parameters, and response to interferon therapy, of IgM antibod y to hepatitis C virus core protein (IgM anti-HCV-core) in the serum o f patients with chronic hepatitis C. Methods: The presence of IgM anti -HCV core was investigated in 42 patients with chronic hepatitis C. Te sts for IgM anti-HCVcore was carried out before interferon therapy. Th e patients received 3 MU of interferon-a three times weekly for 6 mont hs. A response to interferon therapy was defined as normal transaminas e activity and negative viremia at the end of treatment (month 6: resp onse), and a sustained response was defined as normal ALT values and n egative viremia for 6 months after completion of therapy. Results: Six teen patients (38%) displayed IgM anti-HCVcore. The mean Knodell score of the IgM anti-HCVcore-positive patients was significantly higher th an that of the IgM anti-HCVcore-negative patients (11.5 +/- 3.4 vs. 9. 1 +/- 3.1, p = 0.04), and the occurrence of IgM anti-HCVcore tended to be associated with serotype 1 virus (p = 0.08). Finally, a significan tly higher percentage of responders to interferon at the end of therap y were IgM anti-HCVcore negative (p = 0.04), and only one patient with a ratio of sample to cutoff over 2.0 responded to interferon. Conclus ions: IgM anti-HCVcore appears to be a simple serological marker of mo re severe liver disease in patients with chronic hepatitis C and may h ave relevance to the outcome of antiviral therapy.