IGM ANTI-HEPATITIS-C VIRUS IN PATIENTS WITH CHRONIC NON-A, NON-B-HEPATITIS AND THEIR RELATIONSHIP TO VIRAL REPLICATION

Patients with hepatitis C virus; (HCV) infection may have different pa tterns of antibody response to various structural and non-structural v iral antigens. We have correlated the serological patterns to the clin ical features of chronic infection and to viral replication in 68 HCV- Ab-positive patients with chronic liver disease at different stages (1 9 with cirrhosis-hepatocellular carcinoma, 38 with chronic active hepa titis and 11 with chronic persistent hepatitis).Serum samples from eac h patient were assayed for HCV-IgM by enzyme immunoassay and for HCV-R NA by the polymerase chain reaction using primer sets derived from the 5'-non-coding region. The prevalence of HCV-IgM was high (54 patients (79.4%)) and the study showed a good correlation between high values of anti-HCV-IgM and the presence of HCV-RNA in serum, since HCV-RNA wa s detected in 35 of tile 54 IgM-positive patients (64.8%) and notably in 19 of the 20 subjects with high levels of specific IgM. Conversely, all the 35 sera containing HCV-RNA were also reactive for HCV-IgM, wh ile none of the HCV-IgM-negative sera was HCV-RNA reactive. Positivity rates for both HCV-RNA and IgM anti-HCV were higher in the more advan ced stages of disease; thus, the clinical pattern of HCV chronic hepat itis seems to be strictly related to the serological pattern and the p resence of HCV-RNA.